Vitamin D and nutritional supplements in the revalidation of older people after hip surgery

IntroductionHypovitaminosis D is common in older people. Low vitamin D may contribute to hip fracture risk.MethodsDuring a 15-week period all people admitted for revalidation after hip surgery (elective or after fracture) were screened for hypovitaminosis D. A standard substitution was given consisting of 100,000 IU vitamin D at day 1 followed by calcium/vit D 1000/880 once daily together with a high caloric nutritional supplement. Vitamin D, PTH and nutritional parameters were measured at baseline and at follow-up.ResultsOne hundred and three patients were enrolled (78% women, mean age 82.1 ± 6.2 years) of which 82% were treated for hip fracture. In the fracture group there is a significantly higher prevalence of osteoporosis (63.9% versus 20.0%; p ≤ 0.005). Vitamin D insufficiency (< 30 ng/ml) is extremely prevalent in both groups (94.2% versus 92.8%) with levels below 15 ng/ml in respectively 35.3% and 53.0% for the elective and the fracture group. Highest values of PTH were seen in people with the lowest levels of vitamin D. After intervention there is a significant rise in serum vitamin D (15.6–26.3 ng/ml; p ≤ 0.001) and a significant reduction in plasma PTH (40.2–32.1 pg/ml; p ≤ 0.001).ConclusionA majority of patients after hip surgery has vitamin D deficiency. People with traumatic fracture were significantly more osteoporotic. By implementing standard vitamin D and caloric supplementation in the revalidation after hip surgery PTH levels are significantly lowered and nutritional parameters improve.