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Association between Vitamin D Deficiency and Prognosis after Hip Fracture Surgery in Older Patients in a Dedicated Orthogeriatric Care Pathway

  • Original Research
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The journal of nutrition, health & aging

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.

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Aknowledgment

We wish to thank study participants and their families, Sorbonne University and Pitié-Salpétrière University Hospital for contributing to the study.

Author information

Authors and Affiliations

  1. Unit of Peri-Operative Geriatric Care, Department of Geriatrics, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Paris, France

    V. Dauny, S. Thietart, J. Cohen-Bittan, M. Verny, J. Boddaert, L. Zerah & Cédric Villain

  2. Faculté de médecine Sorbonne Université, Paris, France

    V. Dauny, S. Thietart & F. Khiami

  3. Sorbonne Université, UMRS INSERM 1166, Paris, France

    B. Riou

  4. Department of Emergency Medicine, APHP, Hôpital La Pitié-Salpêtrière, Paris, France

    B. Riou

  5. Department of Orthopedic Surgery and Trauma, APHP, Hôpital La Pitié-Salpétrière, Paris, France

    F. Khiami

  6. Rehabilitation unit, APHP, Hôpital Charles Foix, Paris, France

    A. Meziere

  7. Sorbonne Université, UMR CNRS 8256, Team Neuronal Cell Biology & Pathology, Paris, France

    M. Verny

  8. Sorbonne Université, UMRS INSERM 1136, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris, France

    J. Boddaert

  9. Sorbonne Université, UMR INSERM 1135, Paris, France

    L. Zerah

  10. Department of Geriatrics, CHU Caen Normandie, Caen, France, Avenue de la Côte de Nacre, 14000, Caen, France

    Cédric Villain

  11. Normandie Université UNICAEN, INSERM U1075 COMETE, Caen, France

    Cédric Villain

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  1. V. Dauny
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  2. S. Thietart
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  3. J. Cohen-Bittan
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  5. F. Khiami
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  7. M. Verny
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  8. J. Boddaert
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  10. Cédric Villain
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Contributions

All authors of the study contributed to the study design and drafting of the paper. C.V. designed and conducted the analyses. V.D. wrote the first draft and all authors edited the paper.

Corresponding author

Correspondence to Cédric Villain.

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All the experiments in this study comply with the current laws of the country in which they were performed

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The authors declare having no potential source of conflict of interest regarding this article.

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Dauny, V., Thietart, S., Cohen-Bittan, J. et al. Association between Vitamin D Deficiency and Prognosis after Hip Fracture Surgery in Older Patients in a Dedicated Orthogeriatric Care Pathway. J Nutr Health Aging 26, 324–331 (2022). https://doi.org/10.1007/s12603-022-1762-3

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