Vitamin D use and health outcomes after surgery for hip fracture

Authors

Sheila Sprague, McMaster University
Gerard P. Slobogean, University of Maryland School of Medicine
Earl Bogoch, McMaster University
Brad Petrisor, McMaster University
Alisha Garibaldi, McMaster University
Nathan O'Hara, University of Maryland School of Medicine
Mohit Bhandari, McMaster University
Marc Swiontkowski, University of Minnesota
P. J. Devereaux, McMaster University
Gordon Guyatt, McMaster University
Martin J. Heetveld, Spaarne Gasthuis
Kyle Jeray, Greenville Hospital System
Susan Liew, The Alfred
Martin Richardson, University of Melbourne
Emil H. Schemitsch, Western University
Lehana Thabane, McMaster University
Paul Tornetta, Boston University Medical Center
Stephen D. Walter, McMaster University
Paula McKay
Taryn Scott
Helena Viveiros
Marilyn Swinton
Mark Gichuru
Sofia Bzovsky
Diane Heels-Ansdell
Qi Zhou
Lisa Buckingham
Aravin Duraikannan
Deborah Maddock, McMaster University
Nicole Simunovic, McMaster University
Julie Age
Esther M.M. Van Lieshout
Stephanie M. Zielinski, Erasmus MC

Document Type

Article

Publication Date

9-1-2017

Journal

Orthopedics

Volume

40

Issue

5

First Page

e868

Last Page

e875

URL with Digital Object Identifier

10.3928/01477447-20170907-01

Abstract

Copyright © SLACK Incorporated. Daily administration of vitamin D is important for maintaining bone homeostasis. The orthopedic community has shown increased interest in vitamin D supplementation and patient outcomes after fracture. The current study used data from a large hip fracture trial to determine the proportion of patients who consistently used vitamin D after hip fracture surgery and to determine whether supplementation was associated with improved health-related quality of life and reduced reoperation rates. The FAITH study is a multicenter trial of elderly patients with femoral neck fracture treated with internal fixation. The current study asked a subset of patients included in the FAITH study about vitamin D supplementation and categorized them as consistent users, inconsistent users, or nonusers. This study also evaluated whether supplementation was associated with improved quality of life and reduced reoperation rates. The final analysis included 573 patients (mean age, 74.1 years; female, 66.3%; nondisplaced fractures, 72.4%). A total of 18.7% of participants reported no use of vitamin D, 35.6% reported inconsistent use, and 45.7% reported consistent use. Adjusted analysis found that consistent supplementation was associated with a 2.42 increase of the Short Form-12 physical component score 12 months postoperatively (P=.033). However, supplementation was not associated with reduced reoperation rates (P=.386). Despite guidelines recommending vitamin D supplementation, a low proportion of elderly patients with hip fracture use vitamin D consistently, suggesting a need for additional strategies to promote compliance. This study found that the use of vitamin D was associated with a statistically significant but not clinically significant improvement in health-related quality of life after hip fracture. Further research is needed to confirm these findings.