骨创伤患者维生素 D 缺乏的特征及标准化补充方案的应用。
Characterization of vitamin D deficiency and use of a standardized supplementation protocol in orthopaedic trauma patients.
机构信息
Department of Orthopaedic Surgery, Indiana University School of Medicine, 1801 N Senate Blvd, Ste 535, Indianapolis, IN, 46202, USA.
Department of Pharmacy, Eskenazi Health, Indianapolis, IN, USA.
出版信息
Eur J Orthop Surg Traumatol. 2023 May;33(4):955-960. doi: 10.1007/s00590-022-03231-0. Epub 2022 Mar 1.
PURPOSE
The objectives of this study were to assess the incidence of vitamin D deficiency in orthopaedic trauma patients, evaluate the safety and efficacy of a vitamin D supplementation protocol, and investigate the utility of vitamin D supplementation in reducing nonunions.
METHODS
Three hundred seventy patients with operative tibia and/or fibula fractures were retrospectively reviewed. Both overall and matched cohorts were analysed.
RESULTS
Ninety-eight per cent (n = 210) were found to have vitamin D insufficiency (serum 25(OH)D level < 30 ng/ml). There were no cases of vitamin D toxicity following vitamin D replacement. Median follow-up vitamin D level was 22.7 ng/mL. No statistical difference between union rates was found between either the two consecutive cohorts or matched cohorts.
CONCLUSION
This vitamin D replacement protocol was a safe treatment for hypovitaminosis D, but post hoc analysis shows there would need to be over 1200 matched patients to achieve adequate power.
目的
本研究旨在评估骨科创伤患者维生素 D 缺乏的发生率，评估维生素 D 补充方案的安全性和有效性，并探讨维生素 D 补充在减少骨折不愈合中的作用。
方法
回顾性分析了 370 例接受手术治疗的胫骨和/或腓骨骨折患者。对总体和匹配队列进行了分析。
结果
98%（n=210）的患者存在维生素 D 不足（血清 25（OH）D 水平<30ng/ml）。维生素 D 替代治疗后无维生素 D 中毒病例。中位随访时维生素 D 水平为 22.7ng/ml。在两个连续队列或匹配队列之间，愈合率均无统计学差异。
结论
该维生素 D 替代方案治疗维生素 D 缺乏症是安全的，但事后分析表明，需要超过 1200 例匹配患者才能获得足够的效力。
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