Prospective nutritional analysis of a diverse trauma population demonstrates substantial hypovitaminosis D.
OBJECTIVE
There are several metabolic factors known to be important for the maintenance of bone and muscle function. Causes of deficiency are multifactorial and can include such things as geographic region, latitude, and socioeconomic factors. The purpose of this study was to determine the prevalence of metabolic deficiencies.


METHODS
Level 1, urban trauma center.


METHODS
Prospective laboratory evaluation.


METHODS
The subjects included 652 consecutive admits to the orthopaedic surgery service between July 1, 2011, and June 30, 2012.


METHODS
Laboratory evaluation.


METHODS
Metabolic and endocrine profiles included a serum analysis on all patients. Subject data included age, gender, body mass index, month of admission, and type of injury, and subjects' self-reported race, alcohol, recreational drug, and tobacco use were collected.


RESULTS
Six hundred fifty-two subjects with an average age of 41.2 years were evaluated. After data analysis, only 25-hydroxyvitamin D levels were found to be persistently poor across the patient population: 86.2% of subjects were insufficient in 25-hydroxyvitamin D (<30 ng/mL), 53.2% were deficient (<20 ng/mL), and 14.0% had levels <10 ng/mL (severely deficient); 76.7% of the subjects increased skin pigmentation, and the differences in 25-hydroxyvitamin D levels between races were significantly different. African Americans had the highest risk of severe deficiency. 25-Hydroxyvitamin D levels were significantly higher during summer months, with men, and with a lower body mass index, but there were no differences based on age or substance use. Additional laboratory analysis did not reveal significant nutritional deficiency.


CONCLUSIONS
The prevalence of hypovitaminosis D is widespread. This may negatively affect outcomes for orthopaedic patients but would be easily correctable. 25-Hydroxyvitamin D serologic analysis should be considered for all orthopaedic trauma patients.


METHODS
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Department of Orthopedic Surgery, Baylor College of Medicine, Ben Taub General Hospital, Houston, TX.
Benjamin S
BS
Zellner
John R
JR
Dawson
Lee M
LM
Reichel
Kayla
K
Schaefer
Jolie
J
Britt
Cody
C
Hillin
Charles A
CA
Reitman
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D002118:Calcium / Q000097:blood; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D014193:Trauma Centers; D014505:Urban Population; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D014947:Wounds and Injuries / Q000097:blood / Q000453:epidemiology*
D002118:Calcium