Before and after hip fracture, vitamin D deficiency may not be treated sufficiently

Osteoporos Int. 2013 Nov;24(11):2765-73. doi: 10.1007/s00198-013-2400-z. Epub 2013 May 29.


Our findings show that only about 20% of seniors receive vitamin D supplementation prior to their index hip fracture or after the event. We further confirm the high prevalence of severe vitamin D deficiency in this population and show that those who receive supplementation have significantly higher 25-hydroxyvitamin D (25(OH)D) status.

Introduction: The aim of this study is to assess current practice in pre- and post-hip fracture care practice with respect to vitamin D supplementation.

Methods: We surveyed 1,090 acute hip fracture patients age 65 and older admitted to acute care for hip fracture repair; 844 had serum 25-hydroxyvitamin D levels measured upon admission to acute care, and 362 agreed to be followed at 12 month after their hip fracture. Prevalence of vitamin D supplementation was assessed upon admission to acute care (at the time of hip fracture), upon discharge from acute care, and at 6 and 12 months follow-up.

Results: Of 1,090 acute hip fracture patients (mean age 85 years, 78% women, 59 % community-dwelling), 19% had received any dose of vitamin D prior to the index hip fracture, 27% (of 854 assessed) at discharge from acute care, 22 % (of 321 assessed) at 6 month, and 21% (of 285 assessed) at 12 month after their hip fracture. At the time of fracture, 45% had 25(OH)D levels below 10 ng/ml, 81% had levels below 20 ng/ml, and 96% had levels below 30 ng/ml. Notably, 25(OH)D levels did not differ by season or gender but were significantly higher among 164 hip fracture patients, with any vitamin D supplementation compared with 680 without supplementation (19.9 versus 10.8 ng/ml; p < 0.0001).

Conclusion: Only about 20% of seniors receive vitamin D at the time of their fracture and after the event. This is despite the documented 81% prevalence of vitamin D deficiency. Interdisciplinary efforts may be warranted to improve vitamin D supplementation in seniors both before a hip fracture occurs and after.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dietary Supplements / statistics & numerical data*
  • Drug Utilization / statistics & numerical data
  • Family Practice / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Hip Fractures / blood
  • Hip Fractures / etiology*
  • Hip Fractures / prevention & control
  • Hospitalization
  • Humans
  • Male
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Seasons
  • Switzerland / epidemiology
  • Vitamin D / administration & dosage*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / drug therapy*
  • Vitamin D Deficiency / epidemiology


  • Vitamin D
  • 25-hydroxyvitamin D