Vitamin D Deficiency Is Highly Concomitant but Not Strong Risk Factor for Mortality in Patients Aged 50 Year and Older with Hip Fracture
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Background: The purpose of this study was to ascertain the prevalence of vitamin D deficiency and risk factors associated with mortality in patients ≥50-year-of-age with hip fractures. Methods: A total of 489 patients ≥50-year-of-age who sustained a hip fracture from January 2010 to October 2014 were followed-up for a minimum of 1 year. Clinical and radiological outcomes were evaluated including prevalence of vitamin D deficiency. Crude mortality rates were calculated, and the effects of different risk factors on mortality were assessed. Results: Vitamin D deficiency was present in 76.5% of cases (n=237). The prevalence of vitamin D insufficiency was 12. %, and only 11.2% of patients had normal vitamin D levels. Accumulated mortality was 11% (54 patients) at 1 year. A univariate analysis showed that vitamin D deficiency (P=0.012), age (P<0.001), BMI (P<0.001), type of management (P< 0.001), American Society of Anesthesiologists (ASA) score (P=0.009), pre-fracture ambulatory status (P<0.001), and osteoporosis (P< 0.001) were associated with mortality. A multivariate analysis performed using a Cox proportional hazards model demonstrated that ASA score (P=0.001) and pre-fracture ambulatory status (P=0.011) were independently associated with mortality after hip fracture. Conclusions: We did not find a relationship between serum 25-hydroxy-vitamin D levels and mortality after hip fracture, although we observed a high prevalence of vitamin D deficiency and a significant association with mortality in the univariate analysis.
Abstract
Background: The purpose of this study was to ascertain the prevalence of vitamin D deficiency and risk factors associated with mortality in patients ≥50-year-of-age with hip fractures. Methods: A total of 489 patients ≥50-year-of-age who sustained a hip fracture from January 2010 to October 2014 were followed-up for a minimum of 1 year. Clinical and radiological outcomes were evaluated including prevalence of vitamin D deficiency. Crude mortality rates were calculated, and the effects of different risk factors on mortality were assessed. Results: Vitamin D deficiency was present in 76.5% of cases (n=237). The prevalence of vitamin D insufficiency was 12. %, and only 11.2% of patients had normal vitamin D levels. Accumulated mortality was 11% (54 patients) at 1 year. A univariate analysis showed that vitamin D deficiency (P=0.012), age (P<0.001), BMI (P<0.001), type of management (P< 0.001), American Society of Anesthesiologists (ASA) score (P=0.009), pre-fracture ambulatory status (P<0.001), and osteoporosis (P< 0.001) were associated with mortality. A multivariate analysis performed using a Cox proportional hazards model demonstrated that ASA score (P=0.001) and pre-fracture ambulatory status (P=0.011) were independently associated with mortality after hip fracture. Conclusions: We did not find a relationship between serum 25-hydroxy-vitamin D levels and mortality after hip fracture, although we observed a high prevalence of vitamin D deficiency and a significant association with mortality in the univariate analysis.
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