Vitamin D levels in post-acute hip fractured patients and their association with rehabilitation outcomes

Hershkovitz, Avital; Maydan, Gal; Ben-Joseph, Ronen

doi:10.1080/09638288.2021.1971304

Cited by 3 publications

(1 citation statement)

References 44 publications

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“…The vitamin D status was investigated because it significantly affects the functional outcome following hip fracture: low levels of 25-hydroxivitamin D have been consistently shown to predict poor outcomes, likely because of their unfavorable effects on muscle strength, physical performance, body balance, and propensity to falls. 22 , 31 - 33 …”

Section: Methodsmentioning

confidence: 99%

Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study

DI MONACO,

SGARBANTI,

TROMBETTA

et al. 2024

Eur J Phys Rehabil Med

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BACKGROUND Cognitive impairment is a long-known negative prognostic factor after hip fracture. Cognition is usually screened by a single easy-to-administer bedside tool, but recent studies have shown that screening tests may be not enough to rule out cognitive impairment with an unfavorable prognostic role. Unfortunately, data on outcome prediction by further cognitive assessments is sparse. AIM We focused on patients with subacute hip fracture defined cognitively intact or mildly impaired on the screening evaluation performed by the Short Portable Mental Status Questionnaire (SPMSQ). We hypothesized that each of 3 further cognitive tests could independently predict activities of daily living, with optimal prediction of function obtained by performing all three the tests. DESIGN Short-term prospective study. SETTING Rehabilitation ward. POPULATION Inpatients with subacute hip-fracture. METHODS Three cognitive tests were performed on admission to rehabilitation in the patients who made ≤4 errors on the SPMSQ: Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT, immediate and delayed recall) and Frontal Assessment Battery (FAB). We assessed activities of daily living by the Barthel index. Successful rehabilitation was defined with a Barthel Index Score ≥85. RESULTS Each of the three cognitive tests assessed before rehabilitation significantly predicted the Barthel index scores measured at the end of the rehabilitation course in our sample of 280 inpatients. However, only the MoCA score retained its significant predictive role when the scores from the three tests were included together as independent variables in a multiple regression model, with adjustments for a panel of potential confounders (P=0.007). The adjusted odds ratio to achieve successful rehabilitation for a seven-point change in MoCA score was 1.98 (CI 95% from 1.02 to 3.83; P=0.042). CONCLUSIONS Contrary to our hypothesis, MoCA but not RAVLT and FAB retained the prognostic role when the scores from the three tests were evaluated together as potential predictors of functional ability in activities of daily living. CLINICAL REHABILITATION IMPACT In the presence of a normal (or mildly altered) score on the SPMSQ in subacute hip fracture, MoCA scores improve prediction of activities of daily living and should be routinely performed.

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Section: Methodsmentioning

confidence: 99%

Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study

DI MONACO,

SGARBANTI,

TROMBETTA

et al. 2024

Eur J Phys Rehabil Med

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Vitamin D deficiency in hip fracture patients is associated with an increased mortality risk

Bayram,

Kanesan,

Clement

2024

Eur J Orthop Surg Traumatol

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Purpose The aims were to assess whether vitamin D deficiency influenced mortality risk and length of acute hospital stay in patients presenting with a hip fracture. Methods A retrospective study was undertaken including all patients aged over 50 years that were admitted with a hip fracture to a single centre during a 24-month period. Serum vitamin D levels on admission, patient demographics, perioperative variables and mortality were collected. Cox regression analysis was utilised to determine the independent association between serum vitamin D levels and patient mortality. Results The cohort consisted of 1510 patients with a mean age of 81.3 years and 1107 (71.4%) were female. 876 (58.0%) were vitamin D deficient (< 50 nmol/l). The median follow up was 405 (IQR 249 to 610) days. During follow-up there were 464 deaths (30.7%). Vitamin D deficiency was independently associated with higher mortality risk (hazard ratio [HR] 1.26, 95% confidence interval (CI) 1.03 to 1.53, P = 0.022). Male sex (HR 1.64, 95% CI 1.34 to 2.01, P < 0.001) was also associated with a higher mortality risk. Vitamin D deficiency was not associated with length of hospital stay (median difference 0 days, P = 0.207). Conclusion Vitamin D deficiency was independently associated with increased mortality in hip fracture patients, though this finding may be influenced by lack of comprehensive adjustment for comorbidity. While the value of routine serum vitamin D measurement is debated, supplementation during hospital stays is important to reduce falls and fracture risks associated with deficiency.

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Does vitamin D deficiency affect functional outcomes in hip fracture patients? A meta-analysis of cohort studies

Llombart,

Mariscal,

Barrios

et al. 2023

J Endocrinol Invest

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Vitamin D levels in post-acute hip fractured patients and their association with rehabilitation outcomes

Cited by 3 publications

References 44 publications

Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study

Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study

Vitamin D deficiency in hip fracture patients is associated with an increased mortality risk

Does vitamin D deficiency affect functional outcomes in hip fracture patients? A meta-analysis of cohort studies

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