Preoperative vitamin D levels predict recovery following hip fracture surgery

December 20 2021. A study reported on November 30, 2021 in the  Journal of Bone Metabolism  revealed an association between deficient vitamin D levels and diminished functional recovery with prolonged hospitalization among men and women who underwent surgery for hip fracture.

“Low vitamin D level (serum 25-hydroxyvitamin D less than 20 ng/mL) is considered a risk factor for fall, hip fracture and in turn associated with worse outcomes,” authors Chaemoon Lim of the Department of Orthopedic Surgery at Jeju National University Hospital in Korea and colleagues wrote. “However, the effect of vitamin D on postoperative functional recovery and complications after hip fracture has not been completely understood.”

The study included 1,029 individuals aged 65 years or older with a hip fracture that required surgery. Measurement of 25-hydroxyvitamin levels upon hospital admission revealed vitamin D deficiency among 702 patients. Determination of postoperative functional recovery status was based on hospital stay duration and level of assistance needed to ambulate.

Average length of hospitalization was 27.7 days among patients with vitamin D deficiency compared to 20.9 days among those whose levels were considered sufficient. Postoperative functional recovery was significantly less among the deficient group. Vitamin D deficiency was associated with a 52% greater risk of developing postoperative delirium, more than double the risk of developing a blood clot and a greater than three-fold greater risk of pneumonia compared to having sufficient levels.

“Preoperative vitamin D deficiency in hip fractures patients was associated with prolonged duration of hospital stay and decrease of postoperative ambulatory status and may increase the risk of delirium, pneumonia and thromboembolism,” the authors concluded. “Therefore, it is necessary to evaluate the preoperative vitamin D level and prescribe vitamin D supplements to elderly patients with a high probability of hip fracture.”

—D Dye