Prevalence, predictors, and clinical impact of vitamin D deficiency on 12-month outcomes in hip fracture patients
Year: 2026
Type: article
Study design: Observational Study
Abstract: PURPOSE: Vitamin D deficiency (VDD) is common in older adults with osteoporosis, but its prevalence, determinants, and clinical impact in hip fracture (HF) patients remain incompletely defined. This study investigated the prevalence of VDD, associated factors, and 12-month outcomes in HF patients managed within a Fracture Liaison Service program. METHODS: In this prospective cohort study, 934 patients hospitalized for HF were enrolled between March 2023 and March 2025. VDD was defined as serum 25-hydroxyvitamin D [25-(OH)D] < 50 nmol/L. Clinical characteristics, laboratory parameters, and 12-month outcomes were assessed. RESULTS: Overall VDD prevalence was 53.6%, with a median 25-(OH)D concentration of 22 nmol/L among deficient patients. Independent predictors of VDD were male sex (p < 0.001), diabetes mellitus (p = 0.003), dementia (p = 0.013), and active smoking (p = 0.045), while prior vitamin D supplementation was negatively associated (p < 0.001). Decision tree analysis showed VDD prevalence ranging from 17.2% to 86.3% across patient phenotypes. Patients with VDD showed higher levels of bone turnover markers. In unadjusted analyses, VDD was associated with higher 12-month mortality (HR 1.65, 95% CI 1.12-2.42, p = 0.010), an association attenuated and no longer significant after adjustment for age, sex, and comorbidity burden (HR 1.31, 95% CI 0.88-1.96, p = 0.188). No associations were observed between VDD and rehospitalization or refracture rates. CONCLUSION: VDD is highly prevalent in HF patients. Although associated with higher mortality in unadjusted analyses, this relationship appears largely explained by comorbidity burden. These findings highlight the importance of recognizing VDD and implementing targeted vitamin D supplementation strategies in high-risk HF populations.
Authors: Gaetano Paride Arcidiacono, Marco Onofrio Torres, Chiara Ceolin, Giovanni Tripepi, Valentina Camozzi, Anna Bertocco, Mor Peleg Falb, Martin Diogo, Francesca Guidolin, Alberta Cecchinato, Giacomo Voltan, Michela Ferrarese, Maria Grazia Rodà, Elisa Pala, Andrea Angelini, Deris Gianni Boemo, Maria Vittoria Nesoti, Elena Campello, Pietro Ruggieri, Maria Fusaro, Salvatore Minisola, Paolo Simioni, Giuseppe Sergi, Sandro Giannini, Marina De Rui, Stefania Sella, on behalf of the Hip-POS working group
Language: English
Topic: Vitamin D Research Studies
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
Funder: Università degli Studi di Padova
OpenAlex ID: W7166317265