Journal of Isfahan Medical School

Journal of Isfahan Medical School

One-Year Mortality Due to Hip Fracture Following a Single Dose of Intramuscular Vitamin D

Document Type : Original Article (s)

Authors
Hossein Akbari-Aghdam 1
Hamid Reza Hajihashemi 2
Davood Kazemi 3
Hadi Ravanbod 1
1 Assistant Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Resident, Department of Orthopedic Surgery AND Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v36i483.10026
Abstract
Background: Hip fractures due to osteoporosis in elderly are an important health-related concern of community. Hypovitaminosis D is an underlying reason of osteoporosis that can cause hip fracture. In the current study, the effect of single-dose of intramuscular vitamin D on mortality due to intertrochanteric fracture was assessed.Methods: This was a clinical-trial study on 55 patients with intertrochanteric fracture. Patients were randomly divided to two groups of 31 cases under intramuscular vitamin D therapy (Case), and 24 cases without any remedy (Control). Basal vitamin D level was checked. Then, cases were treated with single dose of intramuscular vitamin D (300000 units). Age, gender, and comorbidities were recorded in a checklist.Findings: Cases had mean age of 77.3 ± 11.1 years and controls 78.5 ± 10.2 years (P = 0.69). Gender distribution (P = 0.55), type of fracture based on Evans fracture criteria (P = 0.63), and basal vitamin D (P = 0.50) were not significantly different between the two groups. The mortality rate was 35% in cases and 25% in controls, that was not statistically different (P = 0.40). Age, duration of hospitalization, diabetes mellitus, and type of fracture were predictive factors of mortality due to intertrochantric fracture (P < 0.05 for all).Conclusion: Single dose of intramuscular vitamin D was not effective on one-year mortality of patients with intertrochantric fracture. Age, duration of hospitalization, diabetes mellitus, and unstable fracture were directly in association with one-year mortality of intertrochantric fracture.
Keywords
Hip fractures
Vitamin D
Osteoporosis
  1. Johnell O, Kanis JA. An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 2004; 15(11): 897-902.
  2. L Riska BS, Forsen L, Omsland TK, Sogaard AJ, Meyer HE, Holvik K. Does the Association of Comorbidity with 1-Year Mortality After Hip Fracture Differ According to Gender? The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS). J Am Geriatr Soc 2018; 66(3): 553-8.
  3. Center JR, Bliuc D, Nguyen ND, Nguyen TV, Eisman JA. Osteoporosis medication and reduced mortality risk in elderly women and men. J Clin Endocrinol Metab 2011; 96(4): 1006-14.
  4. Moreno X, Albala C, Lera L, Leyton B, Angel B, Sanchez H. Gender, nutritional status and disability-free life expectancy among older people in Santiago, Chile. PLoS One 2018; 13(3): e0194074.
  5. Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A, et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 2000; 11(8): 669-74.
  6. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, et al. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 2007; 62(7): 744-51.
  7. Nguyen ND, Center JR, Eisman JA, Nguyen TV. Bone loss, weight loss, and weight fluctuation predict mortality risk in elderly men and women. J Bone Miner Res 2007; 22(8): 1147-54.
  8. Burns A, Younger J, Morris J, Baldwin R, Tarrier N, Pendleton N, et al. Outcomes following hip fracture surgery: a 2-year prospective study. Am J Geriatr Psychiatry 2014; 22(8): 838-44.
  9. Frost SA, Nguyen ND, Black DA, Eisman JA, Nguyen TV. Risk factors for in-hospital post-hip fracture mortality. Bone 2011; 49(3): 553-8.
  10. Duque G, Close JJ, de Jager JP, Ebeling PR, Inderjeeth C, Lord S, et al. Treatment for osteoporosis in Australian residential aged care facilities: consensus recommendations for fracture prevention. Med J Aust 2010; 193(3): 173-9.
  11. Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 2011; 22(5): 1277-88.
  12. Murad MH, Elamin KB, Abu Elnour NO, Elamin MB, Alkatib AA, Fatourechi MM, et al. Clinical review: The effect of vitamin D on falls: a systematic review and meta-analysis. J Clin Endocrinol Metab 2011; 96(10): 2997-3006.
  13. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007; 370(9588): 657-66.
  14. Mak JC, Mason RS, Klein L, Cameron ID. An initial loading-dose vitamin D versus placebo after hip fracture surgery: randomized trial. BMC Musculoskelet Disord 2016; 17: 336.
  15. Stockton KA, Mengersen K, Paratz JD, Kandiah D, Bennell KL. Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis. Osteoporos Int 2011; 22(3): 859-71.
  16. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med 2009; 169(6): 551-61.
  17. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005; 293(18): 2257-64.
  18. Autier P, Gandini S. Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med 2007; 167(16): 1730-7.
  19. Nurmi-Luthje I, Luthje P, Kaukonen JP, Kataja M, Kuurne S, Naboulsi H, et al. Post-fracture prescribed calcium and vitamin D supplements alone or, in females, with concomitant anti-osteoporotic drugs is associated with lower mortality in elderly hip fracture patients: a prospective analysis. Drugs Aging 2009; 26(5): 409-21.
  20. Lee YS, Huang HL, Lo TY, Huang CR. Dynamic hip screw in the treatment of intertrochanteric fractures: a comparison of two fixation methods. Int Orthop 2007; 31(5): 683-8.
  21. Heshmat R, Mohammad K, Majdzadeh SR, Forouzanfar MH, Bahrami A, Ranjbar Omrani G, et al. Vitamin D Deficiency in Iran: A Multi-center Study among Different Urban Areas. Iran J Public Health 2008; 37(Suppl): 72-8.
  22. Ramezani M, Sadeghi M. The Prevalence of Vitamin D Deficiency in Adults in Kermanshah, Western Iran. Iran J Public Health 2018; 47(2): 299-300.
  23. Nurmi-Luthje I, Sund R, Juntunen M, Luthje P. Post-hip fracture use of prescribed calcium plus vitamin D or vitamin D supplements and antiosteoporotic drugs is associated with lower mortality: a nationwide study in Finland. J Bone Miner Res 2011; 26(8): 1845-53.
  24. Nugent C, Roche K, Wilson S, Fitzgibbon M, Griffin D, Nichaidhin N, et al. The effect of intramuscular vitamin D (cholecalciferol) on serum 25OH vitamin D levels in older female acute hospital admissions. Ir J Med Sci 2010; 179(1): 57-61.
  25. Kearns MD, Binongo JN, Watson D, Alvarez JA, Lodin D, Ziegler TR, et al. The effect of a single, large bolus of vitamin D in healthy adults over the winter and following year: a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr 2015; 69(2): 193-7.
  26. Crew KD, Xiao T, Thomas PS, Terry MB, Maurer M, Kalinsky K, et al. Safety, Feasibility, and Biomarker Effects of High-Dose Vitamin D Supplementation Among Women at High Risk for Breast Cancer. Int J Food Sci Nutr Diet 2015; 2015(Suppl 1): 1-16.
  27. Kanis JA, Oden A, Johnell O, De LC, Jonsson B, Oglesby AK. The components of excess mortality after hip fracture. Bone 2003; 32(5): 468-73.
  28. Colon-Emeric CS, Mesenbrink P, Lyles KW, Pieper CF, Boonen S, Delmas P, et al. Potential mediators of the mortality reduction with zoledronic acid after hip fracture. J Bone Miner Res 2010; 25(1): 91-7.
  29. Gulcelik NE, Bayraktar M, Caglar O, Alpaslan M, Karakaya J. Mortality after hip fracture in diabetic patients. Exp Clin Endocrinol Diabetes 2011; 119(7): 414-8.
  30. Cenzer IS, Tang V, Boscardin WJ, Smith AK, Ritchie C, Wallhagen MI, et al. One-Year Mortality After Hip Fracture: Development and Validation of a Prognostic Index. J Am Geriatr Soc 2016; 64(9): 1863-8.
Journal of Isfahan Medical School
Volume 36, Issue 483 - Serial Number 483
May and June 2018
Pages 651-657

  • Receive Date 27 April 2018
  • Accept Date 06 April 2022