Impact of frailty in non-surgical fractures in elderly population with vitamin D deficiency: How much is little?

Abstract

Vitamin D is associated to bone health and reduction in the incidence of fractures. However, this condition remains increasing specially during elderly, predisposing to frailty and increasing hospital stay days. The reduction in vitamin D levels could explain the high incidence of fractures as well as mortality. This is an observational transversal retrospective study. This study aimed to determine the relation between frailty and fractures in patients with low vitamin D levels. We found 914 patients with vitamin D levels; however, we included just 319 patients who had previous imaging study, vitamin D determination, and confirmed diagnosis of frailty. Patients with surgical fractures, chronic kidney disease or vitamin D supplementation were excluded from this study. The main fractures related to long hospital stay (> 5 days), frailty, and low vitamin D levels were clavicle fracture; however, scaphoids fracture was related to shorter hospital stay and higher vitamin D levels. Most of fractures happened over 60 years old in women and under 60 years old in men. Vitamin D deficiency was related to long hospital stay in all fractures, despite the deficiency, vitamin D levels over 12 ng/mL were related to better outcomes in all patients; however, serum vitamin D levels related to the incidence of fracture were lower than reported in literature.