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1 in 3 died after hip fracture but only 1 in 14 if add Vitamin D and exercise – RCT April 2017

Impact of 3-Monthly Vitamin D Supplementation Plus Exercise on Survival after Surgery for Osteoporotic Hip Fracture in Adult Patients over 50 Years: A Pragmatic Randomized, Partially Blinded, Controlled Trial.

J Nutr Health Aging. 2017;21(4):413-420. doi: 10.1007/s12603-016-0773-3.
Laiz A alaiz at santpau.cat, Malouf J, Marin A, Longobardi V, de Caso J, Farrerons J, Casademont J.

VitaminDWiki Summary

Exercise + 3 mg of calcifediol once every 90 days after elderly hip fracture
After 4 treatments (1 year) the death rates were 1 in 3 vs 1 in 14

Calcifediol = calcidiol =25-hydroxycholecalciferol =25-hydroxyvitamin D =25(OH)D
VitaminDWiki speculates that they used calcidiol because

  1. Less concern about compliance - 90 days instead of every 17 days or daily
  2. Eliminated concern about the elderly liver not being able to process vitamin D

Note: calcifediol is considered to be 5X more potent than Vitamin D
So 3 mg calcifediol = 15,000 IU every 90 days = 5,000 every 30 days = not much


See also VitaminDWiki


OBJECTIVE:
To determine whether 3-monthly supplementation of an oral vitamin D widely used in Spain (calcifediol) plus daily exercise could influence survival at one and four years after surgery for osteoporotic hip fracture.

DESIGN:
A pragmatic, randomized, partially single-blind placebo-controlled study.

SETTING:
Patients admitted to a tertiary university hospital for acute hip fracture.

PARTICIPANTS:
675 healthy adult patients undergoing surgery for osteoporotic hip fracture were recruited from January 2004 to December 2007.

INTERVENTION:
Patients were randomized to receive either 3-monthly oral doses of 3 mg calcifediol (Hidroferol Choque®) or placebo in the 12 months postsurgery. Patients who received calcifediol were also given an exercise programme. The placebo group received standard health recommendations only.

MEASUREMENTS:
The primary endpoint was survival at 1 year and at 4 year follow-up. We also recorded new fractures, medical complications and anti-osteoporotic treatment compliance.

RESULTS:
We included a total of 88 patients, aged 62 to 99 years. Mean age was 82 years and 88.6% were women. At 12 months, 10 (11.3%) patients had died, 9 of them, from the non-intervention group. At 4 years after surgery, 20 (22.7%) had died, 3 (3.4%) from the intervention group and 17 (19.3%) from the non-intervention group. At this time, survival curve analysis showed 93% survival in the intervention group and 62% in the non-intervention group (p=0.001). At 12-month follow up, there were 18 new fractures, 9 in each group. The non-intervention group had more medical complications, with significant differences at visit 2 (p = 0.04) and 3 (p = 0.02) but not at visit 4 (p = 0.18). No significant differences between groups were found regarding treatment compliance.

CONCLUSION:
3-monthly, oral supplements of 3 mg calcifediol plus daily exercise improved survival at one-year and four-year follow up after surgery for an osteoporotic hip fracture.

PMID: 28346568 DOI: 10.1007/s12603-016-0773-3
Publisher wants $40 for the PDF

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