Endocrine Abstracts (2018) 59 P042 | DOI: 10.1530/endoabs.59.P042

Vitamin D status is associated with physical function, frailty and mortality in older patients admitted with acute illness

Noor Alhamamy1,2, Vinay Reddy-Kolanu2, Neil Gittoes1,3 & Zaki Hassan-Smith1,2,3

1Department of Endocrinology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 2Department of Acute Medicine, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 3Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.

Introduction: Vitamin D deficiency has been implicated in adverse health outcomes related to immunity, metabolism and physical function. Comprehensive assessments are required to characterise vitamin D status and relationships with physical function and frailty markers in the acutely unwell.

Aims: To assess vitamin D and related parameters for patients admitted acutely to hospital who have been tested and to assess the relationship with muscle function and general health outcomes. This analysis will inform development of a prospective study of the impact of vitamin D status on outcomes in acute illness relating to clinical course and rehabilitation.

Methods: 1332 patients aged over 65 admitted to acute medicine between 1/6/2017-1/6/2018 were identified by health informatics. Data were collected on physical function and frailty markers in addition to clinical diagnosis, management and outcomes. A sub-study was formed of 766 patients where vitamin D status was assessed.

Results: 739 were female and 539 male. Median serum 25OH-vitamin D was 31 nmol/L (IQR:14-58). Patients in the lowest quartile for vitamin D had significantly longer length of stay compared to those in the highest quartile (median 34 days, IQR 21–56 vs. 10 days, IQR 4–18, P<0.05), lower abbreviated mental test scores (AMT10) (5/10, IQR 3–6 vs 8/10, IQR 5–9 P<0.05), higher Waterlow scores (19, IQR 14–22 vs. 13, IQR 13–17) and a trend towards higher falls scores (2, IQR 1–3 vs 1, IQR 0–3) and lower Manchester mobility scores (5, IQR 2–6 vs 6, IQR 5–6). 32% of patients died in the lowest vitamin D quartile vs. 14% in the highest quartile.

Conclusions: Vitamin D status is closely associated with measures of physical function and frailty in acutely unwell older patients. Prospective supplementation studies in this patient group are required to establish causality, investigate mechanisms assess impact on rehabilitation potential and clinical outcomes

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