Vitamin D Levels, Physical and Biochemical Characteristicsof South East Asian Patients with Osteoporotic Hip Fractures

Chandran, Manju; Howe, Tet Sen; Goh, Seo Kiat; Hh, Li; Ng, Alvin Choong Meng; Zhang, Rong Fang; Koh, Joyce Suang Bee

doi:10.15605/jafes.027.02.09

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…Vitamin D has gained much interest recently with the revelation of its role far beyond bone metabolism. Many studies have reported associations between suboptimal vitamin D levels and various comorbidities, including [1] cancers of the prostate, colon, pancreas, ovary, stomach, and breast [2]; cardiovascular diseases, including hypertension, myocardial infarction, and congestive heart failure [3]; diabetes mellitus [4]; infectious diseases, including HIV [5]; autoimmune diseases such as rheumatoid arthritis, Crohn's disease, and multiple sclerosis [6]; stroke [7]; chronic obstructive pulmonary diseases; and [8] mental health issues [7,9,[12][13][14][15][17][18][19][20][21]. When the comorbidities were bundled and represented collectively as CCI, the association appears to be negated.…”

Section: Discussionmentioning

confidence: 99%

“…Vitamin D deficiency is also highly prevalent among this population, ranging from 55 to 96.7% [2][3][4]. Even in the tropical country of Singapore, vitamin D deficiency was previously reported to be highly prevalent among hip fracture cohorts [5]. The high prevalence of vitamin D deficiency in elderly patients with multiple comorbidities that had hip fractures might not be just a coincidence.…”

Section: Introductionmentioning

confidence: 99%

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The effect of the comorbidity burden on vitamin D levels in geriatric hip fracture

Moo

Kam

Cher

et al. 2020

BMC Musculoskelet Disord

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Background: Elderly patients with hip fractures often have multiple medical comorbidities, and vitamin D deficiency is common in this population. Accumulating evidence links low vitamin D levels to various comorbidities. However, very little is known about the collective impact of comorbidities on vitamin D levels. The Charlson Comorbidity Index (CCI) is a validated comorbidity burden index. We hypothesized that a high CCI score is associated with vitamin D deficiency in elderly patients with hip fracture. Methods: A retrospective cohort study was conducted among all hospitalized elderly patients aged > 60 years admitted for low-energy hip fracture in a single tertiary hospital from 2013 to 2015. Data regarding patient demographics, fracture type, serum 25-hydroxyvitamin D3 levels and age-adjusted CCI score were collected and analysed. Results: Of the 796 patients included in the study, 70.6% (n = 562) of the patients were women and the mean age was 77.7 ± 8.0 years. The mean vitamin D level was 20.4 ± 7.4 ng/mL, and 91.7% ofhospitalized elderly patients with hip fracture had inadequate vitamin D level. There was no correlation between the individual serum vitamin D level with respect to age-adjusted CCI (Pearson correlation coefficient = 0.01; p = 0.87). After stratifying the CCI scores into low and high comorbidity burden groups (i.e., with scores 1-2 and ≥ 3), there was no relationship between the 2 subgroups for age-adjusted CCI and vitamin D levels (p = 0.497). Furthermore, there was also no association among age, gender, fracture type, and smoking status with the mean 25(OH)D level (p > 0.05). Conclusion: Low vitamin D levels were highly prevalent in our hip fracture cohort. There was no relationship between the CCI score and vitamin D levels in the geriatric hip population. The comorbidity burden in geriatric patients with hip fractures did not seem to be a significant factor for vitamin D levels.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of the comorbidity burden on vitamin D levels in geriatric hip fracture

Moo

Kam

Cher

et al. 2020

BMC Musculoskelet Disord

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“…Furthermore, 20% of such patients remained partially or fully dependent, around 40% had reduced mobility, and an increasing proportion lived in an institutionalised home. 4,5 In the United States, 48% of patients with hip fracture aged ≥65 years had a degree of delirium before, during, or after surgery. 6 Delirium is a severe neuropsychiatric syndrome that is common and serious in older patients with hip fracture.…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for delirium in older patients with hip fracture

Mallya

Mok

et al. 2021

Asian Journal of Gerontology and Geriatrics

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Introduction. Delirium is a common complication of hip fracture that can be avoided or ameliorated by careful anticipatory case management. We aimed to investigate the incidence and risk factors of delirium in older patients with hip fracture treated in our structured integrated care unit, and to evaluate the impact of delirium on healthcare utilisation.Methods. We retrospectively reviewed records of patients aged ≥60 years and admitted to our unit from December 2014 to September 2018 with low-impact hip fracture. Our unit has implemented a structured integrated care programme based on the NICE guidelines. Primary outcome measure was the incidence of delirium. The diagnosis of delirium was established using the Confusion Assessment Method. Secondary outcome measures included length of hospital stay, readmission within 30 days of discharge, and mortality within 30 days and 1 year.Results. A total of 1304 patients were included and classified as nondelirium (349 men and 815 women; mean age, 79.2 years) and delirium (49 men and 91 women; mean age, 82.3 years). The overall withinepisode incidence of delirium was thus 10.7%. Independent risk factors for delirium in older patients with hip fractures were age (odds ratio [OR]=1.028, p=0.02), surgical treatment (OR=2.202, p=0.006), dementia (OR=2.066, p=0.001), elevated body temperature (OR=1.966, p=0.001), urinary tract infection (OR=2.431, p<0.001), and acute coronary syndrome (OR=4.587, p<0.001). Those with delirium had prolonged hospitalisation of ≥10 days (OR=2.033, p<0.001) and higher mortality within 30 days (OR=3.408, p=0.002) and 1 year (OR=1.894, p=0.004). Conclusion.The incidence of delirium was low in the present study, compared with most studies. The structured integrated care programme in our unit enables early recognition of delirium for prevention and management of delirium in older patients with hip fracture and might contribute to better outcomes.

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Chronic joint pain and handgrip strength correlates with osteoporosis in mid-life women: a Singaporean cohort

et al. 2017

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Vitamin D Levels, Physical and Biochemical Characteristicsof South East Asian Patients with Osteoporotic Hip Fractures

Cited by 5 publications

References 38 publications

The effect of the comorbidity burden on vitamin D levels in geriatric hip fracture

The effect of the comorbidity burden on vitamin D levels in geriatric hip fracture

Incidence and risk factors for delirium in older patients with hip fracture

Chronic joint pain and handgrip strength correlates with osteoporosis in mid-life women: a Singaporean cohort

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