25-hydroxyvitamin D and Inflammation in Older Acute Hip Fracture Patients

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C Ezeobika¹, M Ahmed¹, A Punekar¹, J Jose¹, J Bamisaye¹, H Jouni¹, A Wray¹, J Thummin¹, A Michael², B Mukherjee¹, A Nandi¹, N Obiechina¹
¹ Queen's Hospital, Burton on Trent, UK; ² Russells Hall Hospital, Dudley, UK
Perioperative care for surgical patients
Falls
Joints
Bone Health
Prescribing and medication management

Abstract

Introduction

  • Preoperative systemic inflammation has been shown to worsen postoperative outcome in emergency surgical patients.
  • C-reactive protein (mg/L)/Albumin (g/L) ratio is a well validated inflammation marker.
  • Studies have shown an inverse relationship between 25-hydroxyvitamin D level and markers of inflammation. Vitamin D deficiency has been previously shown to be associated with inflammation.

Aims and Objectives

  • To determine the relationship between 25-hydroxyvitamin D level and CRP/Albumin ratio in older acute hip fracture patients.
  • To explore the impact of gender on this relationship.

Methods

  • A retrospective review of electronic notes from the hip fracture database was carried out on hip fracture patients attending a single trauma centre from January to December 2022.
  • Anonymised data were extracted from the database. Patients aged 60 years and older who sustained an acute hip fracture were included. Patients with incomplete data were excluded. The IBM SPSS 29 software was used for statistical analysis.
  • Descriptive statistics was used for baseline characteristics. Linear regression was used to determine correlation.

Results

  • A total of 293 patients were analysed: 82 males and 211 females with a mean age of 81.6(SD 8.28) and 83.2(SD 7.85) years respectively.
  • Mean 25-hydroxyvitamin D levels were 39.1 (SD 25.0) and 49.7 (SD 29.01) nmols/L respectively.
  • Mean CRP/Albumin ratio was 0.94 (SD 1.51) and 0.71 (SD 1.34).
  • There was a negative, statistically significant correlation between 25-hydroxyvitaminD and CRP/Albumin ratio in male patients but not in the females (r = -.274; p = .013 & r = - .035; p = .61) respectively.

Conclusion

  • In this study, 25-hydroxyvitamin D levels are inversely correlated with markers of inflammation (CRP/Albumin ratio) in older male hip fracture patients but not older female hip fracture patients. More studies are needed to clarify whether vit D lowers inflammation or inflammation lowers 25-hydroxyvitamin D concentrations and to investigate the gender difference.

Presentation