Hypovitaminosis D in Orthopaedic Trauma: Which Guidelines Should Be Followed?
Abstract
OBJECTIVE: To evaluate the risk factors for hypovitaminosis D and to determine the baseline vitamin D supplementation associated with normal vitamin D levels at presentation.
DESIGN: Prospective observational study.
SETTING: Level I trauma center.
PATIENTS: This study included 259 adult patients undergoing operative treatment for orthopaedic trauma (OTA 11-15, 21-23, 31-34, 41-44, 61-62, 70C, 81-82, 87) between January 1, 2014, and December 31, 2014.
INTERVENTION: Prospective, observational study.
MAIN OUTCOMES: Association of hypovitaminosis D with patient characteristics, injury factors, and vitamin D supplementation.
RESULTS: Univariate predictors of hypovitaminosis D included a lack of preinjury supplementation, non-white race, younger age, female sex, non-Medicare insurance, smoking, obesity, Charlson Comorbidity Index <2, and high-energy mechanism. On multivariate analysis, preinjury supplementation was associated with a lower risk (odds ratio: 0.31, 95% confidence interval: 0.15-0.63, P = 0.001) and non-white race was associated with a higher risk (odds ratio: 3.63, 95% confidence interval: 1.58-8.37, P = 0.001) of hypovitaminosis D. Logistic regression analysis found a dose-dependent relationship between vitamin D supplementation and hypovitaminosis D. Each 100-IU increase in vitamin D supplementation was associated with an 8% decrease in the risk of hypovitaminosis D.
CONCLUSIONS: A lack of preinjury supplementation and non-white race were independently associated…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 259 participants or records.
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