Daily supplementation with 800 IU of vitamin D3 insufficient for achievement of vitamin D adequacy in elderly hip fracture patients

.Achievement of adequate vitamin D level is crucial for the treatment of hip fracture patients. A majority of elderly patients after hip fracture in Israel do not receive an appropriate and sufficient vitamin D and calcium supplementation in the community. The aim of this work was to assess the effect of 800 IU/day vitamin D3 supplementation on vitamin D status and plasma PTH in elderly hip fracture patients. Patients and methods: 122 consecutive elderly patients after surgical hip fracture correction, aged 72.7 ± 9.46, were enrolled in the Post-Surgical Treatment Program (PSTP). Serum 25(OH)D3 and plasma PTH levels were assessed during initial hospital stay and at consecutive quarterly follow-up visits. Results: At baseline 118 (97.5%) patients had 25(OH)D3 serum level < 30 ng/mL. Forty (32.8%) patients were vitamin D deficient. After 3 months 29 (24%) patients were adherent to the supplement. The drop out rate at 1 year was 62%. The major reason for the discontinuation of participation was non-compliance. Thirty four adherent (27.8%) patients achieved 25(OH)D3 concentration of 25 ng/mL at13.45 ± 4.9 months. Conclusions: Majority of elderly hip fracture patients had inadequate 25(OH)D3 serum level and had not achieved an adequate vitamin D status with daily supplementation of 800 IU of vitamin D during 24 months follow up period. Supplementation strategies using periodic single high dose of vitamin D might be more appropriate and should be considered in these patients.