Abstract
Vitamin D deficiency is common amongst elderly patients resulting in fragility fractures. Following fragility fractures, patients require vitamin D to be checked prior to initiating bone protection, e.g zoledronic acid/ denosumab. Ideally, all patients should have their first dose of bone protection prior to being discharged from hospital to reduce the risks of fragility fracture.
In this project, carried out in Trafford General Hospital (TGH) amongst patients from orthogeriatric wards, we had observed that the time taken for these results varied significantly depending on the hospital location where patients had their samples taken.
The patient population consisted of patients who suffered a fragility fracture and would be classed as frail. Our analysis suggested significantly prolonged processing times of vitamin D samples in Trafford General Hospital. The median processing time for vitamin D samples at Trafford General Hospital falls behind that of other hospitals in the Manchester Foundation Trust (MFT) network.
This project proposed a strategy to shorten the treatment time of vitamin D replacement from 4 weeks to 1 week, which is now being actively practiced in Trafford General and Wythenshawe Hospitals
Comments
Question
Hello and thank you for your poster regarding Vitamin D. What consideration has been made to administering vitamin D loading to all patients with a fragility fracture and eliminate the check of serum vitamin D levels?
In my trust I have removed this issue by commencing rapid loading regime of Vit D for all patients that we want to give IV bisphosphonates - without waiting for the Vit D result. We are using rapid regime of 60,000 units OD for 5 days, and we give Zol on D3 of loading or later.
If the Vit D comes back normal before the end of the loading, we just switch to maintenance dose early.