In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
The importance of vitamin D for musculoskeletal health has long been recognized , and awareness of significant extra-skeletal effects in health and disease is rapidly emerging .
Although it has been possible for many decades to quantify serum markers of vitamin D deficiency , and to correct deficiency at low cost and with high safety , the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest .
To the present , these data have not been the subject matter of formal review .
Accordingly , we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery .
An initial loading-dose vitamin D versus placebo after hip fracture surgery: baseline characteristics of a randomized controlled trial (REVITAHIP)
Background Hypovitaminosis D is particularly common among older people with a proximal femoral ( hip ) fracture . There are currently no agreed strategies for vitamin D replenishment after hip fracture surgery . The REVITAHIP Study is a multisite , double-blinded r and omized-controlled trial investigating the effects of an oral vitamin D loading dose on gait velocity after hip fracture surgery . We describe the baseline characteristics of participants , aim ing to document hypovitaminosis D and its associations after hip fracture . Methods Participants , over 65 , recruited within 7 days following hip fracture surgery from 3 Australia hospitals , were r and omly allocated to receive a loading dose of vitamin D3 ( 250,000IU ) or placebo , followed by oral maintenance vitamin D3/calcium ( 800 IU/500 mg ) and the usual hip fracture rehabilitation pathway . Demographic and clinical data were collected , including surgical procedure , pre-fracture functional status , Mini Mental State Examination ( MMSE ) score , serum 25-hydroxyvitamin D ( 25-OHD ) , Verbal Rating Scale ( VRS ) for pain , grip strength and gait velocity . The associations of baseline 25-OHD levels with demographic and clinical data were assessed using Pearson ’s correlation , ANOVA and regression analyses . Results Two-hundred- and -eighteen people with hip fracture participated in the study . Mean age was 83.9+/-7.2 years , 77 % were women and 82 % lived in private homes . Fifty-six percent had a subcapital fracture . Mean comorbidity count was 3.13+/-2.0 . Mean MMSE was 26.1+/-3.9 . Forty-seven percent of participants had hypovitaminosis D ( < 50 nmol/L ) . Multivariate regression models demonstrated higher baseline vitamin D levels were significantly associated with higher premorbid Barthel index scores , lower post-operative VRS pain levels and use of vitamin D. Conclusion This study cohort shared similar demographic characteristics and comorbidities with other cohorts of people with hip fracture , with the probable exception of less cognitive impairment . Hypovitaminosis D was not as prevalent as previously documented . Patients taking vitamin D supplements and with higher premorbid Barthel index , reflecting greater independence and activity , tended to have higher 25-OHD levels at baseline . Further , lower VRS pain ratings following surgery were associated with higher vitamin D levels . Such associations will need further investigation to determine causation . ( ANZCTR number , ACTRN12610000392066).Trial registration The protocol for this study is registered with the Australian New Zeal and Clinical Trials Registry ANZCTRN ACTRN12610000392066
In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
The importance of vitamin D for musculoskeletal health has long been recognized , and awareness of significant extra-skeletal effects in health and disease is rapidly emerging .
Although it has been possible for many decades to quantify serum markers of vitamin D deficiency , and to correct deficiency at low cost and with high safety , the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest .
To the present , these data have not been the subject matter of formal review .
Accordingly , we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery .