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Vitamin D deficiency in adult fracture patients: prevalence and risk factors.
Eur J Trauma Emerg Surg. 2016 Jun; 42(3):369-78.EJ

Abstract

PURPOSE

Although vitamin D levels are not routinely monitored in outpatient fracture patients, identification of fracture patients with a deficient vitamin D status may be clinically relevant because of the potential role of vitamin D in fracture healing. This study aimed to determine the prevalence of and risk factors for vitamin D deficiency in non-operatively treated adult fracture patients.

PATIENTS AND METHODS

Vitamin D levels were determined in a cross-sectional study of adult patients, who were treated non-operatively for a fracture of the upper or lower extremity in the outpatient clinic of a level 1 trauma center, during one calendar year. Potential risk factors for (severe) vitamin D deficiency were analyzed using multivariable logistic regression analysis.

RESULTS

A total of 208 men and 319 women with a mean age of 49.7 years (SD 19.9) were included. In this population, 71 % had a serum calcidiol <75 nmol/L, 40 % were vitamin D deficient (serum calcidiol <50 nmol/L) and 11 % were severely vitamin D deficient (serum calcidiol <25 nmol/L). Smoking and season (winter and spring) were independent risk factors for vitamin D deficiency. An increasing age, a non-Caucasian skin type, winter and smoking were identified as independent risk factors for severe vitamin D deficiency. The use of vitamin D, alcohol consumption and higher average daily sun exposure were independent protective factors against (severe) vitamin D deficiency.

CONCLUSION

Given the potential role of vitamin D in fracture healing, clinicians treating adult fracture patients should be aware of the frequent presence of vitamin D deficiency during the winter, especially in smoking and non-Caucasian patients. Research on the effect of vitamin D deficiency or supplementation on fracture healing is needed, before suggesting routine monitoring or supplementation.

Links

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Authors+Show Affiliations

Gorter EA
Department of Surgery and Traumatology, Leiden University Medical Centre, K6-50, P.O. Box 9600, 2300, Leiden, The Netherlands. e.a.gorter@lumc.nl.
Krijnen P
Department of Surgery and Traumatology, Leiden University Medical Centre, K6-50, P.O. Box 9600, 2300, Leiden, The Netherlands.
Schipper IB
Department of Surgery and Traumatology, Leiden University Medical Centre, K6-50, P.O. Box 9600, 2300, Leiden, The Netherlands.

MeSH

AgedCross-Sectional StudiesFemaleFractures, BoneHumansMaleMiddle AgedOutpatient Clinics, HospitalPrevalenceRisk FactorsSeasonsUnited KingdomUnited StatesVitamin DVitamin D Deficiency

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26194498

Citation

Gorter, E A., et al. "Vitamin D Deficiency in Adult Fracture Patients: Prevalence and Risk Factors." European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society, vol. 42, no. 3, 2016, pp. 369-78.
Gorter EA, Krijnen P, Schipper IB. Vitamin D deficiency in adult fracture patients: prevalence and risk factors. Eur J Trauma Emerg Surg. 2016;42(3):369-78.
Gorter, E. A., Krijnen, P., & Schipper, I. B. (2016). Vitamin D deficiency in adult fracture patients: prevalence and risk factors. European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society, 42(3), 369-78. https://doi.org/10.1007/s00068-015-0550-8
Gorter EA, Krijnen P, Schipper IB. Vitamin D Deficiency in Adult Fracture Patients: Prevalence and Risk Factors. Eur J Trauma Emerg Surg. 2016;42(3):369-78. PubMed PMID: 26194498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D deficiency in adult fracture patients: prevalence and risk factors. AU - Gorter,E A, AU - Krijnen,P, AU - Schipper,I B, Y1 - 2015/07/21/ PY - 2014/10/27/received PY - 2015/06/26/accepted PY - 2015/7/22/entrez PY - 2015/7/22/pubmed PY - 2017/5/26/medline KW - Fracture KW - Fracture healing KW - Risk factors KW - Vitamin D KW - Vitamin D deficiency SP - 369 EP - 78 JF - European journal of trauma and emergency surgery : official publication of the European Trauma Society JO - Eur J Trauma Emerg Surg VL - 42 IS - 3 N2 - PURPOSE: Although vitamin D levels are not routinely monitored in outpatient fracture patients, identification of fracture patients with a deficient vitamin D status may be clinically relevant because of the potential role of vitamin D in fracture healing. This study aimed to determine the prevalence of and risk factors for vitamin D deficiency in non-operatively treated adult fracture patients. PATIENTS AND METHODS: Vitamin D levels were determined in a cross-sectional study of adult patients, who were treated non-operatively for a fracture of the upper or lower extremity in the outpatient clinic of a level 1 trauma center, during one calendar year. Potential risk factors for (severe) vitamin D deficiency were analyzed using multivariable logistic regression analysis. RESULTS: A total of 208 men and 319 women with a mean age of 49.7 years (SD 19.9) were included. In this population, 71 % had a serum calcidiol <75 nmol/L, 40 % were vitamin D deficient (serum calcidiol <50 nmol/L) and 11 % were severely vitamin D deficient (serum calcidiol <25 nmol/L). Smoking and season (winter and spring) were independent risk factors for vitamin D deficiency. An increasing age, a non-Caucasian skin type, winter and smoking were identified as independent risk factors for severe vitamin D deficiency. The use of vitamin D, alcohol consumption and higher average daily sun exposure were independent protective factors against (severe) vitamin D deficiency. CONCLUSION: Given the potential role of vitamin D in fracture healing, clinicians treating adult fracture patients should be aware of the frequent presence of vitamin D deficiency during the winter, especially in smoking and non-Caucasian patients. Research on the effect of vitamin D deficiency or supplementation on fracture healing is needed, before suggesting routine monitoring or supplementation. SN - 1863-9941 UR - https://www.unboundmedicine.com/medline/citation/26194498/Vitamin_D_deficiency_in_adult_fracture_patients:_prevalence_and_risk_factors_ DB - PRIME DP - Unbound Medicine ER -