Aim: This study evaluated the prevalence of vitamin D deficiency in patients admitted with low trauma fracture (LTF). We also explored whether there was a rationale to offer appropriate and safe high dose vitamin D supplementation on admission for patients who are not already on vitamin D supplementation to avoid delay in commencing active bone protection treatment if required.
Patients and methods: Using the FLS database, 1460 patients over the age of 50 years seen and assessed during their in-patient admission between January 2015 and December 2017 were identified. Data on serum vitamin D level were collected and analysed.
Results: Of the 1460 inpatients seen by the FLS team, data on vitamin D results from 831 patients were included in the analysis. 629 patients were excluded as 331 did not have their vitamin D levels checked and 298 patients were already on vitamin D supplementation on admission. From the 831 patients, 68% (n=558) were female and 32% (n=273) were males. Using the National Osteoporosis Society classification, 19% of patients were vitamin D replete (serum vitamin D level of >50 nmol/l), 24% were vitamin D insufficient (serum vitamin D level of 3150 nmol/l) and 57% were vitamin D deficient (serum vitamin D level of < 30 nmol/l). Subgroup analysis showed that vitamin D deficiency is highly prevalent amongst patients of 60 years and over and those admitted with fractured neck of femur.
Conclusion: This study highlights the high prevalence of vitamin D deficiency in patients admitted with LTF. This finding raises the potential benefit of a pragmatic approach of offering this group of patients with reasonable and adequate loading dose of vitamin D without the need for testing. A follow up study to determine whether this regimen actually renders patients replete with vitamin D is now needed.