title: Before and after hip fracture, vitamin D deficiency may not be treated sufficiently.
abstract: 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.
  
  
  BACKGROUND
  The aim of this study is to assess current practice in pre- and post-hip fracture care practice with respect to vitamin D supplementation.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: S
authors.initials: S
authors.lastname: Maier
authors.forename: E
authors.initials: E
authors.lastname: Sidelnikov
authors.forename: B
authors.initials: B
authors.lastname: Dawson-Hughes
authors.forename: A
authors.initials: A
authors.lastname: Egli
authors.forename: R
authors.initials: R
authors.lastname: Theiler
authors.forename: A
authors.initials: A
authors.lastname: Platz
authors.forename: H B
authors.initials: HB
authors.lastname: Staehelin
authors.forename: H-P
authors.initials: HP
authors.lastname: Simmen
authors.forename: C
authors.initials: C
authors.lastname: Meier
authors.forename: W
authors.initials: W
authors.lastname: Dick
authors.forename: D
authors.initials: D
authors.lastname: Grob
authors.forename: A
authors.initials: A
authors.lastname: von Eckardstein
authors.forename: H A
authors.initials: HA
authors.lastname: Bischoff-Ferrari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D006760:Hospitalization; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012621:Seasons; D013557:Switzerland / Q000453:epidemiology; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D