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

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.

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

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

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

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.

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.

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.

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
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