Vitamin D and Postoperative Recovery in Elderly Ribeirinhos—Riverside Amazon Communities with Femur Fractures

TL;DR

Vitamin D supplementation in elderly Amazon communities is linked to shorter hospital stays after femur fracture surgery.

Contribution

Demonstrates vitamin D's potential role in improving postoperative recovery in elderly populations with limited sun exposure.

Findings

Supplemented patients had 37% shorter hospitalization compared to non-supplemented patients.

Vitamin D levels were significantly higher in supplemented patients.

Supplemented patients had lower blood glucose and higher ionized calcium levels.

Abstract

Background/Objectives: Vitamin D deficiency is prevalent in elderly populations and may impact surgical recovery. Despite the equatorial location, vitamin D insufficiency affects many elderly Ribeirinhos in the Brazilian Amazon. This study investigated whether pre-existing vitamin D supplementation influences postoperative outcomes in elderly Ribeirinhos following femur fracture surgery, while examining metabolic parameters and documenting chronic disease prevalence. Methods: This prospective cohort study enrolled 60 elderly Ribeirinhos patients (≥65 years) admitted for femur fracture surgery at the Regional Hospital of Lower Amazon. Twenty-two patients had participated in a vitamin D supplementation program (50,000 IU monthly, 3–6 months) prior to admission; 38 had not. Primary outcomes were hospitalization duration and serum 25-hydroxyvitamin D levels. Secondary outcomes included ionized calcium, blood glucose, and comorbidity documentation. Results: The supplementation group was associated with significantly shorter hospitalization (14.32 ± 0.79 vs. 22.61 ± 0.88 days, p < 0.0001), representing 37% reduction. Vitamin D levels were markedly higher in supplemented patients (50.26 ± 2.55 vs. 21.74 ± 0.84 ng/mL, p < 0.0001). Ionized calcium was elevated in the supplementation group (1.29 ± 0.01 vs. 1.08 ± 0.02 mmol/L, p < 0.001) without hypercalcemia. Blood glucose was lower in supplemented patients (83.8 ± 1.4 vs. 152.2 ± 9.6 mg/dL, p < 0.001). Medical records revealed that 73.3% had hypertension and 31.7% had diabetes, with 25% having both conditions. Conclusions: Pre-existing vitamin D supplementation was associated with reduced hospitalization duration following femur fracture surgery, though causality cannot be inferred due to observational design. Community-based vitamin D programs may warrant further investigation in vulnerable populations, with randomized trials needed.

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