An initial loading-dose vitamin D versus placebo after hip fracture surgery: randomized trialReport as inadecuate




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BMC Musculoskeletal Disorders

, 17:336

Rehabilitation, physical therapy and occupational health

Abstract

BackgroundImproving vitamin D 25-OHD status may be an important modifiable factor that could reduce disability severity, fall-rates and mortality associated after hip fracture surgery. Providing a loading-dose post-surgery may overcome limitations in adherence to daily supplementation.

MethodIn this randomized, double-blind, placebo-controlled trial, 218 adults, aged 65-years or older, requiring hip fracture surgery were assigned to receive a single loading-dose of cholecalciferol 250,000 IU vitamin-D3, the REVITAHIP - Replenishment of Vitamin D in Hip Fracture strategy or placebo, both receiving daily vitamin-D800 IU and calcium 500 mg for 26-weeks. Outcome measures were 2.4 m gait-velocity, falls, fractures, death Week-4, 25-OHD levels, quality-of-life measure EuroQoL and mortality at weeks-2, 4 and 26.

ResultsMean age of 218 participants was 83.97.2 years and 77.1 % were women. Baseline mean 25-OHD was 52.723.5nmol-L, with higher levels at Week-2 73 vs 66 nmol-L; p = .019 and Week-4 83 vs 75 nmol-L; p = .030 in the Active-group, but not at Week-26. At week-4, there were no differences in 2.4 m gait-velocity 0.42 m-s vs 0.39 m-s, p = .490, fractures 2.7 % vs 2.8 %, p = .964 but Active participants reported less falls 6.3 % vs 21.1 %, χ = 4.327; p = 0.024, with no significant reduction in deaths at week-4 1 vs 3, p = 0.295, higher percentage reporting ‘no pain or discomfort’ 96.4 % vs 88.8 %, p = 0.037, and trended for higher EuroQoL-scores p = 0.092 at week-26. One case of hypercalcemia at week-2 normalised by week-4.

ConclusionAmong older people after hip fracture surgery, the REVITAHIP strategy is a safe and low cost method of improving vitamin-D levels, reducing falls and pain levels.

Trial registrationThe protocol for this study is registered with the Australian New Zealand Clinical Trials Registry ANZCTRN ACTRN12610000392066 Date of registration: 14-05-2010.

KeywordsHip fracture Vitamin D Randomized controlled trial Falls Rehabilitation  Download fulltext PDF



Author: Jenson CS Mak - Rebecca S. Mason - Linda Klein - Ian D. Cameron

Source: https://link.springer.com/







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