Sprague Sheila, Slobogean Gerard P, Bogoch Earl, Petrisor Brad, Garibaldi Alisha, O'Hara Nathan, Bhandari Mohit
Orthopedics. 2017 Oct 1;40(5):e868-e875. doi: 10.3928/01477447-20170907-01.
Daily administration of vitamin D is important for maintaining bone homeostasis. The orthopedic community has shown increased interest in vitamin D supplementation and patient outcomes after fracture. The current study used data from a large hip fracture trial to determine the proportion of patients who consistently used vitamin D after hip fracture surgery and to determine whether supplementation was associated with improved health-related quality of life and reduced reoperation rates. The FAITH study is a multicenter trial of elderly patients with femoral neck fracture treated with internal fixation. The current study asked a subset of patients included in the FAITH study about vitamin D supplementation and categorized them as consistent users, inconsistent users, or nonusers. This study also evaluated whether supplementation was associated with improved quality of life and reduced reoperation rates. The final analysis included 573 patients (mean age, 74.1 years; female, 66.3%; nondis-placed fractures, 72.4%). A total of 18.7% of participants reported no use of vitamin D, 35.6% reported inconsistent use, and 45.7% reported consistent use. Adjusted analysis found that consistent supplementation was associated with a 2.42 increase of the Short Form-12 physical component score 12 months postoperatively (P=.033). However, supplementation was not associated with reduced reoperation rates (P=.386). Despite guidelines recommending vitamin D supplementation, a low proportion of elderly patients with hip fracture use vitamin D consistently, suggesting a need for additional strategies to promote compliance. This study found that the use of vitamin D was associated with a statistically significant but not clinically significant improvement in health-related quality of life after hip fracture. Further research is needed to confirm these findings. [Orthopedics. 2017; 40(5):e868-e875.].
每日补充维生素D对于维持骨骼稳态很重要。骨科领域对骨折后补充维生素D及患者预后的关注度日益增加。本研究利用一项大型髋部骨折试验的数据，以确定髋部骨折手术后持续使用维生素D的患者比例，并确定补充维生素D是否与改善健康相关生活质量及降低再次手术率有关。FAITH研究是一项针对老年股骨颈骨折患者行内固定治疗的多中心试验。本研究询问了FAITH研究中的一部分患者关于维生素D补充的情况，并将他们分为持续使用者、非持续使用者或未使用者。本研究还评估了补充维生素D是否与生活质量改善及再次手术率降低有关。最终分析纳入了573例患者（平均年龄74.1岁；女性占66.3%；无移位骨折占72.4%）。共有18.7%的参与者报告未使用维生素D，35.6%报告非持续使用，45.7%报告持续使用。校正分析发现，持续补充维生素D与术后12个月简短健康调查问卷12项身体成分评分增加2.42有关（P = 0.033）。然而，补充维生素D与再次手术率降低无关（P = 0.386）。尽管有指南推荐补充维生素D，但髋部骨折老年患者持续使用维生素D的比例较低，这表明需要采取额外策略来提高依从性。本研究发现，髋部骨折后使用维生素D与健康相关生活质量在统计学上有显著改善，但在临床上无显著改善。需要进一步研究来证实这些发现。[《骨科》。2017；40(5):e868 - e875。]
