An exploration of serum 25-hydroxyvitamin D levels after unstable femoral intertrochanteric fractures in community-dwelling elderly.

Abstract

Objectives: Inadequate vitamin D is related to increased fall risk, which leads to hip fractures among the elderly. Therefore, this study aimed to explore vitamin D levels and the variables potentially influencing the total hospitalization time of community-dwelling elderly patients with unstable femoral intertrochanteric fractures.

Methods: Between 2020-2024, 75 elderly patients treated with total hip replacement (THR) were retrospectively analyzed. Patients were divided into the deficient (<20 ng/mL, n=46), insufficient (20 to 29.99 ng/mL, n=16), and normal (≥30 ng/mL, n=13) serum 25-hydroxyvitamin D (25(OH)D) groups. Presence of delirium status, postoperative intensive care entrance, number of chronic diseases, preoperative waiting, and total hospitalization time after THR were recorded.

Results: The cohorts' mean serum 25(OH)D level was 20.11ng/mL. The deficient, insufficient, and normal serum 25(OH)D level groups displayed no significant difference in the postoperative intensive care entrance (p=0.547) and the presence of delirium (p=0.947). The multiple linear regression model indicated that elderly patients' total hospitalization increases with the coefficients as the preoperative waiting time (β=0.466, p=0.001) and the number of chronic diseases (β=0.263, p=0.011) increase. Serum 25(OH)D level did not impact patients' total hospitalization time (β=-0.072, p=0.474).

Conclusion: This study indicated that community-dwelling elderly patients with unstable femoral intertrochanteric fractures had significantly decreased serum 25(OH)D levels. Reducing preoperative waiting time and monitoring and addressing chronic diseases may decrease total hospitalization. Efforts should focus on achieving and maintaining adequate vitamin D levels through supplementation post-hospitalization.