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

• Published in: BMC musculoskeletal disorders Vol. 21; no. 1; p. 524
• Main Authors: Moo, Ing How, Kam, Carmen Jia Wen, Cher, Eric Wei Liang, Peh, Bryan Ce Jie, Lo, Chung Ean, Chua, David Thai Chong, Lo, Ngai Nung, Howe, Tet Sen, Koh, Joyce Suang Bee
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.08.2020; BioMed Central; BMC
• Subjects: Age; Aged; Aged, 80 and over; Charlson comorbidity index; Comorbidity; Demography; Diabetes; Disease; Elderly patients; Female; Fractures; Fractures (Injuries); Gender; Geriatrics; Heart failure; Hip; Hip fracture; Hip Fractures - diagnosis; Hip Fractures - epidemiology; Hospital patients; Humans; Male; Medical research; Metabolism; Musculoskeletal diseases; Older people; Patients; Population; Retrospective Studies; Statistical analysis; Vitamin D; Vitamin D Deficiency - diagnosis; Vitamin D Deficiency - epidemiology; Vitamin deficiency; Singapore; Vitamin D; Hip fracture; Charlson comorbidity index
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-020-03554-1

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. 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. 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). 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.