Centre on Aging and Mobility, University of Zurich and Waid City Hospital, Department of Geriatrics and Aging Research, University Hospital Zurich, Gloriastrasse 25, CH-8091, Zurich, Switzerland.
Osteoporos Int. 2013 Nov;24(11):2765-73. doi: 10.1007/s00198-013-2400-z. Epub 2013 May 29.
Our findings show that only about 20% of seniors receive vitamin D supplementation prior to their index hip fracture or after the event. We further confirm the high prevalence of severe vitamin D deficiency in this population and show that those who receive supplementation have significantly higher 25-hydroxyvitamin D (25(OH)D) status.
The aim of this study is to assess current practice in pre- and post-hip fracture care practice with respect to vitamin D supplementation.
We surveyed 1,090 acute hip fracture patients age 65 and older admitted to acute care for hip fracture repair; 844 had serum 25-hydroxyvitamin D levels measured upon admission to acute care, and 362 agreed to be followed at 12 month after their hip fracture. Prevalence of vitamin D supplementation was assessed upon admission to acute care (at the time of hip fracture), upon discharge from acute care, and at 6 and 12 months follow-up.
Of 1,090 acute hip fracture patients (mean age 85 years, 78% women, 59 % community-dwelling), 19% had received any dose of vitamin D prior to the index hip fracture, 27% (of 854 assessed) at discharge from acute care, 22 % (of 321 assessed) at 6 month, and 21% (of 285 assessed) at 12 month after their hip fracture. At the time of fracture, 45% had 25(OH)D levels below 10 ng/ml, 81% had levels below 20 ng/ml, and 96% had levels below 30 ng/ml. Notably, 25(OH)D levels did not differ by season or gender but were significantly higher among 164 hip fracture patients, with any vitamin D supplementation compared with 680 without supplementation (19.9 versus 10.8 ng/ml; p < 0.0001).
Only about 20% of seniors receive vitamin D at the time of their fracture and after the event. This is despite the documented 81% prevalence of vitamin D deficiency. Interdisciplinary efforts may be warranted to improve vitamin D supplementation in seniors both before a hip fracture occurs and after.
我们的研究结果表明，只有约 20%的老年人在发生髋部骨折前或之后接受维生素 D 补充。我们进一步证实了该人群中严重维生素 D 缺乏症的高发率，并表明接受补充的患者 25-羟维生素 D（25(OH)D）水平显著更高。
本研究旨在评估髋部骨折前后维生素 D 补充的当前实践情况。
我们调查了 1090 名年龄在 65 岁及以上因髋部骨折入住急性护理病房接受髋部骨折修复的急性髋部骨折患者；844 名患者在入住急性护理病房时测量了血清 25-羟维生素 D 水平，其中 362 名同意在髋部骨折后 12 个月进行随访。评估了在入住急性护理病房时（髋部骨折时）、从急性护理病房出院时以及 6 个月和 12 个月随访时的维生素 D 补充情况。
在 1090 名急性髋部骨折患者（平均年龄 85 岁，78%为女性，59%为社区居住者）中，19%在发生指数性髋部骨折前接受了任何剂量的维生素 D 治疗，27%（854 名评估者）在从急性护理病房出院时，22%（321 名评估者）在 6 个月时，21%（285 名评估者）在髋部骨折后 12 个月时接受了维生素 D 治疗。在骨折时，45%的患者 25(OH)D 水平低于 10ng/ml，81%的患者水平低于 20ng/ml，96%的患者水平低于 30ng/ml。值得注意的是，与没有补充的 680 名患者相比，在 164 名接受任何维生素 D 补充的髋部骨折患者中，25(OH)D 水平明显更高（19.9 与 10.8ng/ml；p<0.0001）。
只有约 20%的老年人在发生骨折时和之后接受维生素 D 治疗。尽管维生素 D 缺乏症的发病率为 81%，但实际接受治疗的比例却很低。可能需要采取跨学科的努力，以改善髋部骨折发生前和发生后老年人的维生素 D 补充。
