Effect of high-dosage cholecalciferol and extended physiotherapy on complications after hip fracture: a randomized controlled trial
Bischoff-Ferrari HA, Dawson-Hughes B, Platz A, Orav EJ, Stähelin HB, Willett WC, Can U, Egli A, Mueller NJ, Looser S, Bretscher B, Minder E, Vergopoulos A, Theiler R
Archives of internal medicine · 136 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2010-05-10 · Arch Intern Med · vol. 170 · número 9 · pág. 813
- Editorial
- American Medical Association
- Citado
- 210 citas · más que el 100% de estudios similares · 21.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 24 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · OTHER-OA
- Áreas de investigación
- Hip and Femur Fractures · Balance, Gait, and Falls Prevention · Bone health and osteoporosis research
- Palabras clave
- hip fracture, vitamin D3, home exercise program, falls, hospital readmission, elderly patients, vitamin D supplementation, postoperative complications
- MeSH
- humans, hip fractures, recurrence, cholecalciferol, combined modality therapy, patient readmission, multivariate analysis, regression analysis, poisson distribution, double-blind method, accidental falls, dose-response relationship, drug, aged, aged, 80 and over, switzerland, female, male, physical therapy modalities, bone density conservation agents, drug-related side effects and adverse reactions
1 autor
- Heike Annette Bischoff-Ferrari🇨🇭 · autor de correspondenciaUniversity of Zurich; University Hospital Zurich
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Care of elderly patients after hip fracture is not well established.
Methods
We enrolled 173 patients with acute hip fracture who were 65 years or older (79.2% women; mean age, 84 years; 77.4% living at home). Using a factorial design, we randomly allocated patients to extended physiotherapy (PT) (supervised 60 min/d during acute care plus an unsupervised home program) vs standard PT (supervised 30 min/d during acute care plus no home program; single-blinded), and to cholecalciferol therapy, 2000 vs 800 IU/d (double-blinded). Primary outcome was rate of falls; secondary outcome was rate of hospital readmissions during the 12-month follow-up. All analyses included 173 individuals and used multivariate Poisson regression analyses.
Results
At baseline, 50.9% of participants had 25-hydroxyvitamin D levels of less than 12 ng/mL and 97.7% of less than 30 ng/mL. We documented 212 falls and 74 hospital readmissions. Because this was a factorial design trial, all analyses tested the main effect of each treatment while controlling for the other in 173 participants. Extended vs standard PT reduced the rate of falls by 25% (95% confidence interval [CI], -44% to -1%). Cholecalciferol treatment, 2000 vs 800 IU/d, did not reduce falls (28%; 95% CI, -4% to 68%), but reduced the rate of hospital readmissions by 39% (95% CI, -62% to -1%).
Conclusions
Extended PT was successful in reducing falls but not hospital readmissions, whereas cholecalciferol treatment, 2000 IU/d, was successful in reducing hospital readmission but not falls. Thus, the 2 strategies may be useful together because they address 2 different and important complications after hip fracture.
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