title: Prevalence of 25-hydroxyvitamin D deficiency in the acute inpatient rehabilitation population and its effect on function.
abstract: OBJECTIVE
  To assess the prevalence of 25-hydroxyvitamin D (25[OH]D) insufficiency and deficiency in the acute inpatient rehabilitation setting, identify risk factors associated with low serum 25(OH)D levels, and assess whether hypovitaminosis D affects the function of rehabilitation patients.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Academic acute rehabilitation facility.
  
  
  METHODS
  Patients (N=101) admitted for acute inpatient rehabilitation between September 2008 and December 2008.
  
  
  METHODS
  Serum 25(OH)D levels drawn within 24 hours of admission.
  
  
  METHODS
  25(OH)D level, total/motor/cognitive FIM efficiency.
  
  
  RESULTS
  Considering patients not receiving 25(OH)D supplementation at the time of admission, 23.0% were 25(OH)D sufficient, 68.9% were insufficient, and 8.1% were deficient. Patients receiving 25(OH)D supplementation at the time of admission had significantly higher 25(OH)D levels than patients not receiving 25(OH)D supplementation (33.4±12.8 vs 23.7±11.4ng/mL; P=.001). A total of 72.2% of patients with any fracture and 80.0% of patients with fracture due to fall were not receiving supplementation at the time of admission; 72.2% of patients with any fracture and 73.3% of patients with fracture due to fall were 25(OH)D insufficient. Unadjusted total FIM efficiency scores were statistically significantly different by 25(OH)D status (2.96±1.42 vs 2.29±1.41ng/mL; P=.039). However, 25(OH)D level was not a significant predictor of total FIM efficiency score after controlling for demographic and clinical factors.
  
  
  CONCLUSIONS
  Of acute rehabilitation patients, 77% are 25(OH)D insufficient or deficient at admission. 25(OH)D supplementation is associated with a greater 25(OH)D level in these patients; however, almost half those supplemented had 25(OH)D levels less than the reference range. Most inpatients with fracture due to fall were transferred to acute inpatient rehabilitation without 25(OH)D supplementation despite clear guidelines indicating its use in this situation.
authors.affiliation: Wayne State University, Rehabilitation Institute of Michigan, Detroit, MI 48201, USA. apellicane@hotmail.com
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Pellicane
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Wysocki
authors.forename: Trudy R
authors.initials: TR
authors.lastname: Mallinson
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Schnitzer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000208:ethnology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D