Cic edizioni internazionali
Clinical Cases in mineral and bone metabolism

The use of cholecalciferol in patients with hip fracture

Original Article, 48 - 53
doi: 10.11138/ccmbm/2017.14.1.048
Tag this article
Abstract
Enhanced HTML Full text PDF
Introduction. Major osteoporotic fractures are steadily increasing due to population aging. Programs of secondary prevention against refracture are essential to decrease morbidity and mortality and the cost for individuals and the society. Vitamin D supplementation and optimization of calcium intake are of a pivotal importance to start specific osteoporosis treatment and for its safety and efficacy. Cholecalciferol is the most widely employed drug for vitamin D supplementation,
Purpose. Aim of this study was to assess the trends in the use of vitamin D supplements containing cholecalciferol in the population of hip fracture patients older than 65 years, resident in the region of Tuscany (Italy) in the years 2011-2015 and to describe vitamin D status in a subgroup of this individuals directly referred to a bone clinic for further evaluation after hip osteoporotic fracture.
Methods. Data were retrieved from the electronic anonymous regional administrative database administered by the Region of Tuscany (Italy) in the years 2011-2015 within the T.A.R.Ge.T. project (Trattamento Appropriato delle Rifratture Geriatriche in Toscana, i.e., “Appropriate treatment of geriatric refractures in Tuscany”), a program endorsed by the region itself. Data pertaining to cholecalciferol prescriptions and hospital discharge codes were retrieved and appropriately crossed to get data on the use of cholecalciferol supplements in patients before and after a hip fracture.
A retrospective analysis was carried out in a subgroup of subjects (n 254) appropriately referred to the local fracture liaison service after the major osteoporotic fracture and vitamin D status in terms of serum 25(OH) vitamin D levels was assessed.
Results. The majority of subjects experiencing a hip fracture (98.2% and 88.3% in 2011 and 2015, respectively) did not receive vitamin D supplements at the time of the fracture event. Although a trend in increase in prescriptions for cholecalciferol supplements could be observed in the years of the study, the percentage of treated individuals remained low even after the fracture, since only 30-35% of subjects receives cholecalciferol supplements at one year after the fracture. Cholecalciferol remained the most prescribed drug in this population, while a substantial decrease of cholecalciferol in association with calcium salts was observed. The use of high doses of cholecalciferol has decreased in this population, while diminished the use of the drops has been accompanied by an increase in prescriptions of single monthly dose supplements.
Conclusions. The correction of vitamin D inadequacy is preliminary to any treatment for osteoporosis and together with calcium may reduce fracture risk by itself.
The prescription of vitamin D supplements is low in patients before and after a hip fracture in a Mediterranean region and despite the overall increase in vitamin use and abuse in the general population. Proper educational programs and active fracture liaison services are needed in order to bridge this gap.

Vol. XV (No. 1) 2018 January - April

  1. From the Editor-in-Chief
    Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.007
  2. The use of null-hypothesis significance testing: issues and solutions
    Gronchi G., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.009
  3. Role of Mediterranean diet in bone health
    Migliaccio S., Marrocco C., Mocini E., Lenzi A., Greco E.A.
    doi: 10.11138/ccmbm/2017.15.1.016
  4. The Mediterranean diet for bone health in osteoporosis. Children and adolescents
    Pampaloni B., Quattrini S., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.019
  5. Parmigiano Reggiano cheese: a super-food for bone health
    Pampaloni B., Cianferotti L., Ciampi V., Nocetti M., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.029
  6. Pain from osteoporotic fractures: rationale of therapeutic options
    Hans G. Kress
    doi: 10.11138/ccmbm/2017.15.1.036
  7. New therapeutic strategies in the management of chronic pain related to osteoporosis
    Arghetti S., Magenta P., Racagni M.
    doi: 10.11138/ccmbm/2017.15.1.041
  8. Atypical femur fractures
    Cozzi Lepri A., Capone A., Del Prete A., Soderi S., Muncibì F., Civinini R.
    doi: 10.11138/ccmbm/2017.15.1.043
  9. Surgical strategies for high-energy fractures in patients with osteoporosis
    Cozzi Lepri A., Capone A., Del Prete A., Soderi S., Soderi S., Muncibì F., Innocenti M.
    doi: 10.11138/ccmbm/2017.15.1.060
  10. Sequential therapy: the way to go to prevent fragility fractures
    Gonnelli S., Alessandri M., Caffarelli C.
    doi: 10.11138/ccmbm/2017.15.1.066
  11. Atypical fractures following prolonged bisphosphonate use: a report of two cases
    Daniel-Lavee G., Nudelman P., Deltoff M., Shtarker H.
    doi: 10.11138/ccmbm/2017.15.1.070
  12. Osteoporosis treatment following a low trauma wrist fracture presenting to the Accident and Emergency Department from 2011 to 2015
    Sim Yeap S., Mat Akhir N.S., Thirunavukkarasu V., Thambiah S.C., Samsudin I.N., Zahari Sham S.Y., Balan P., Hew1 F.L., Chan S.P.
    doi: 10.11138/ccmbm/2017.15.1.074
  13. Low intestinal tract adenomatous polyps regression in FAP patients by dietary-induced erbeta upregulation
    Tonelli F., Fabbri S., Ficari F., Batignani G., Femia A.P., Caderni G., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.079
  14. Calcific arteriolopathy beyond chronic kidney disease. The role of hemochromatosis and vitamin K antagonists
    Rodelo-Haad R.-H., De La Puebla Gimenez R.F., Ortega R., Rodriguez M., Aljama P.
    doi: 10.11138/ccmbm/2017.15.1.085
  15. Successful treatment of gonadotropin releasing hormone induced severe pregnancy and lactation-associated osteoporosis with teriparatide
    Tahsini Tekantapeh S., Khabbazi A.
    doi: 10.11138/ccmbm/2017.15.1.089
  16. Serious osteoporomalacia with vertebral fracturing progression in bariatric surgery: case report
    Bruno R., Seriolo C., Palermo A., Nardi A., Molfetta L.
    doi: 10.11138/ccmbm/2017.15.1.094
  17. Late diagnosis of angioleiomyoma of the knee: a case report
    Galanakos S.P., Mavrogenis A.F., Ignatiadis I., Macheras G.A.
    doi: 10.11138/ccmbm/2017.15.1.097
  18. A rare case of Melnick Needles syndrome. Case report and brief review of literature
    Mangaraj S., Choudhury A.K., Mishra I., Patro D., Baliarsinha A.K.
    doi: 10.11138/ccmbm/2017.15.1.100
  19. Coexistence of torus palatinus and acromegaly, an association with a common origin
    Morales J., Folleco M.
    doi: 10.11138/ccmbm/2017.15.1.103
  20. Thoracic and lumbar spinal stenosis in a patient with Klippel-Feil syndrome
    Igoumenou V.G., Karantzoulis V.G., Vazifehdan F.
    doi: 10.11138/ccmbm/2017.15.1.107
  21. Acute deafness as the first symptom of paraneoplastic syndrome: experience of two cases
    Wang X., Yu X.
    doi: 10.11138/ccmbm/2017.15.1.111
  22. Severe secondary osteoporosis in a premenopausal woman: should a specific treatment for osteoporosis be started?
    Baleanu F., Iconaru L., Karmali R., Body J.-J.
    doi: 10.11138/ccmbm/2017.15.1.115
  23. Osteogenesis imperfecta type V: clinico-radiological diagnosis of two cases in a limited resource setting
    Chawla M., Bhardwaj G.
    doi: 10.11138/ccmbm/2017.15.1.119
  24. Multi-organ extraosseous 99mTc-HMDP uptake in a case of metastatic melanoma
    Calandri E., Aretano I., Pultrone M., Liberatore M.
    doi: 10.11138/ccmbm/2017.15.1.123
  25. Bilateral transient osteoporosis of the hip. A case report and review of the literature
    Pallis D., Florin Georgiou D., Rizou S., Symeonidou Z., Sarzi-Puttini P., Troupis T., Casale R.
    doi: 10.11138/ccmbm/2017.15.1.128
  26. Effects of endocrine disrupting compounds on Vitamin D circulating levels
    Fossi C., Pampaloni B., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.132
Last Viewed articles: la lista degli ultimi x visitati.
  1. The use of cholecalciferol in patients with hip fracture
    Cianferotti L., Parri S., Gronchi G., Civinini R., Brandi M.L.
    doi: 10.11138/ccmbm/2017.14.1.048
credits