Association between Vitamin D Deficiency and Prognosis after Hip Fracture Surgery in Older Patients in a Dedicated Orthogeriatric Care Pathway - 17/12/24

Abstract |
Objectives |
Vitamin D deficiency is common in patients undergoing hip fracture surgery (HFS) and has been found to be associated with poor post-operative outcome in other settings. This study aimed to analyze the association between vitamin D status and prognosis after HFS.
Design |
Observational, prospective, single-center study.
Setting and Participants |
All patients admitted in a perioperative geriatric unit between 2009 and 2020 for HFS were included. MEASUREMENTS: A moderate vitamin D deficiency was defined by a vitamin D level between 25 and 75 nmol/1 and a severe deficiency by a vitamin D level <25 nmol/1. Primary endpoint was mortality 6 months after surgery. Secondary endpoints were bacterial infections and delirium during hospitalization. Odds ratio (OR) and 95% confidence interval (95%CI) were computed using logistic regression models with adjustment for confounders.
Results |
1197 patients were included (median age 87 years, IQR [82-91]). Median vitamin D level was 55 nmol/1 (IQR [30–75 nmol/1]). Moderate and severe vitamin D deficiencies were reported in 53% and 21% of patients, respectively. There was no significant association between moderate or severe vitamin D deficiencies and 6-month mortality (OR 0.91, 95%CI [0.59–1.39], and OR 1.31, 95%CI [0.77–2.22], respectively), bacterial infection (OR 0.89, 95%CI [0.60–1.31] and OR 1.55, 95%CI [0.99–2.41], respectively), nor delirium (OR 1.03, 95%CI [0.75–1.40], and OR 1.05, 95%CI [0.70–1.57], respectively). CONCLUSION: Vitamin D deficiency was not associated with mortality, bacterial infection or delirium after HFS. Our results suggest that comorbidities, functional status and post-operative complications are the main determinants of post-operative outcome after HFS.
Le texte complet de cet article est disponible en PDF.Key words : Vitamin D, hip fracture, mortality, bacterial infection, delirium
Plan
Vol 26 - N° 4
P. 324-331 - avril 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
