Blackmores Institute

Studying 290 patients undergoing hip fracture repair from a multisite study in North America researchers found that those with higher concentrations of vitamin D (25(OH)D had higher rates of walking at 30 days post-surgery, and greater mobility at 60 days.Researchers measured serum albumin, vitamin D (25(OH)D), and intact parathyroid hormone to determine whether [25(OH)D] concentration or the Geriatric Nutritional Risk Index (GNRI) is associated with mortality or rates of walking in a patient cohort after hip fracture surgery.“Patients were characterised according to 25(OH)D &lt;12 ng/mL, 12 to &lt;20 ng/mL, 20 to &lt;30 ng/mL, or ≥30 ng/mL and the Geriatric Nutritional Risk Index (GNRI) was categorised into major/moderate nutritional risk (&lt;92), some risk (92 to &lt;98), or in good nutritional status (≥98),” the authors explained.Results showed that compared with patients with &lt;12 ng/mL, those with higher 25(OH)D concentrations had higher rates of walking at 30 days (P = 0.031); 12 to &lt;20 ng/mL (adjusted OR: 2.61; 95% CI: 1.13, 5.99); 20 to &lt;30 ng/mL (3.48; 1.53, 7.95); ≥30 ng/mL (2.84; 1.12, 7.20).“Successful ambulation and functional recovery after surgery are important outcomes in this patient population. However, even with improved surgical techniques, the recovery rate of ambulation and one-year mortality rate has remained the same for decades. Thus, it is important to examine factors that influence postoperative functional outcomes and mortality. Low 25(OH)D concentrations and malnutrition are common disorders in elderly patients with hip fracture and often occur together since both are complications of poor nutritional intake,” the authors said.The study also found there was also greater mobility at 60 days (P = 0.028) in patients with higher 25(OH)D compared with the reference group (&lt;12 ng/mL) and poor nutritional status (GNRI &lt;92) showed an overall trend to reduce mobility (unadjusted P = 0.044 and adjusted P = 0.056) at 30 but not at 60 days. There was no association of vitamin D or GNRI with mortality at either time reported. “Several variables prior to fracture are associated with walking recovery, but it is still unclear which aspects of a geriatric assessment influence mobility. Many patients lose their independence during this time, leading to high rates of mortality and functional disability and healthcare expenses after hip fracture. While it was not shown that circulating intact parathyroid hormone was an independent predictor of mobility or mortality in this study and that GNRI was a reliable predictor of short-term mortality, the authors suggest this may be partially related to the low mortality and/or low incidence of major malnutrition in the current population.“This study provides new evidence that, when 25(OH)D concentration is &gt;12 ng/mL, there is a higher rate of walking without human assistance at 30 and 60-day follow-up after hip fracture surgery. In addition, poor nutritional status in this population was less reliably associated with reduced mobility. Given the high prevalence of hip fracture surgery, and findings in the current study, addressing potential modifiable risk factors with treatment modalities to improve recovery should be explored in a future randomised controlled trial,” the authors concluded.
 
 Source:
 Am J Clin Nutr. 2020. DOI: <a href="https://doi.org/10.1093/ajcn/nqaa029 ">10.1093/ajcn/nqaa029</a>

Regaining mobility after a hip fracture may be compromised by vitamin D deficiency according to new research published in The American Journal of Clinical Nutrition.

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