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Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016

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

The journal of nutrition, health & aging, pp 1-8, First online: 08 July 2016
Ana Laiz , J. Malouf, A. Marin, V. Longobardi, J. de Caso, J. Farrerons, J. Casademont

VitaminDWiki Summary

88 osteoporotic hip fracture patients
Deaths

3-monthly oral doses of
3 mg calcifediol + exercise
Placebo
1 year1% 10%
4 year3.4% 19.3%

Note: Calcifediol = calcidiol = 25-hydroxycholecalciferol = 25-hydroxyvitamin D = 25(OH)D)
Wonder why they used Calcifediol. Vitamin D works as well if liver is OK and is far less expensive
Wonder why they used 3 monthly dosing. every 20 days is far better
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.

References free online


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