Category: Calcium/Bone Disorders

PREVALENCE OF VITAMIN D DEFICIENCY AND ASSOCIATED FRACTURE RISK IN GERIATRIC TRAUMA PATIENTS

Monday, Apr 8
1:00 AM – 2:00 AM

Objective :

The prevalence of Vitamin D deficiency (VDD) among older adults in the United States ranges widely from 20 to 100% and is associated with an increased risk of osteoporosis, falls, and poor healing. Identifying those at risk of VDD can expedite treatment and avoid negative outcomes. This study identifies the prevalence of VDD in geriatric trauma patients presenting with falls and its relation to traumatic fractures (Fx).


 


 


Methods :

This was a prospective study collecting data on patients 65 years of age and older who presented to a Level 1 Trauma Center for a fall between 06/2018 and 08/2018 and had their 25-hydroxyvitamin D level measured. Data collected include demographics, documented fall-risk, length of hospital stay, history of osteoporosis, depression, and diabetes mellitus. Excluded were patients with seizures, end-stage renal disease, and chronic glucocorticoid use. Vitamin D (VitD) levels in ng/ml were divided into sufficient (>30), insufficient (20-30), and deficient (<20) and are reported as n (%) and analyzed by Chi-square or Fisher's exact test as appropriate. Statistics were performed using SAS version 9.4 with a level of significance at p<0.05.


Results :

Out of 63 total patients, 15 (23.8%) were VDD and 14 (22.2%) were VitD insufficient. Among the VitD insufficient and deficient patients, 35.7% and 6.77% were already on VitD supplements, respectively. 79.4% of falls were mechanical in nature. The remainder of falls, in descending order, were due to syncope, unknown, alcohol and presyncope. 100% of VDD patients sustained a Fx, most commonly of the lower extremity vs 73.6% of the VitD sufficient patients (p=0.042). VitD insufficient patients sustained a fracture at a higher rate of 78.6%. The association with >1 Fx was not statistically significant among deficient (13.3%), insufficient (28.5%), and sufficient (14.7%) groups<./p>


Discussion :

Every VDD patient sustained a fall-related Fx, suggesting a correlation between deficiency and Fx risk. Despite prior VitD supplementation, many patients were still found to have insufficient or deficient levels, highlighting the need for better monitoring and treatment.





 


Conclusion :

VDD among geriatric trauma patients who present with a mechanical fall carries a statistically significant higher risk for traumatic fractures than those patients who are VitD sufficient. Identifying geriatric patients with VDD, close monitoring of levels and optimizing VitD treatment may decrease the risk of fall-associated fractures.

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Monisha Priyadarshini Kumar

Resident Physician, PGY2
Cleveland Clinic Akron General
Akron, Ohio

NA

Taylor Kann

Resident Physician, PGY2
AKRON GENERAL MEDICAL CENTER, Ohio

NA

Jessica Krizo

Director of research
AKRON GENERAL MEDICAL CENTER

NA

Caroline Mangira

Biostatistician
AKRON GENERAL MEDICAL CENTER

na

Ali Mallat

Attending Physician
AKRON GENERAL MEDICAL CENTER

NA

Farid Muakkassa

Attending Physician
AKRON GENERAL MEDICAL CENTER

NA

Monisha Priyadarshini Kumar

Resident Physician, PGY2
Cleveland Clinic Akron General
Akron, Ohio

NA

Monisha Priyadarshini Kumar

Resident Physician, PGY2
Cleveland Clinic Akron General
Akron, Ohio

NA