Journal of the American Medical Directors Association
Original StudyVitamin D Deficiency/Insufficiency Practice Patterns in a Veterans Health Administration Long-Term Care Population: A Retrospective Analysis
Section snippets
Methods
A list of veterans residing in the ECC between January 1, 2001, and December 31, 2006, was extracted from the computerized patient record system (CPRS). All ECC patients during this time period were screened for inclusion; patients younger than 65 years old, hemodialysis patients, and patients with history of parathyroidectomy were excluded. All ECC patients meeting inclusion criteria with documented vitamin D levels during the specified time period were evaluated. This research protocol was
Results
There were 2218 unique admissions to the ECC between January 1, 2001, and December 31, 2006 (Figure 1). A total of 229 patients (10%) had at least one serum vitamin D measurement; 90% of patients did not have a serum vitamin D level measured. Seventy-two percent of patients with a serum vitamin D level met inclusion criteria for the study (n = 164). Patients who were younger than 65 and/or were receiving hemodialysis were excluded (n = 65). Of those 164 patients meeting inclusion criteria,
Discussion
Few studies have examined vitamin D status in elderly, male, long-term care patients. Our study revealed a very low frequency (10%) of vitamin D screening in our study population. In addition, among those patients in our predominantly male, long-term care, veteran population who had vitamin D levels assessed, our study found a high rate of vitamin D insufficiency and deficiency.
The high prevalence of vitamin D deficiency among screened ECC residents is consistent with the results of a study in
Conclusions
Our study suggests that vitamin D insufficiency/deficiency is prevalent among elderly, institutionalized, predominantly male veterans in a VA hospital Extended Care Center. In addition, few patients in our study who were identified to have low vitamin D levels received adequate treatment and follow-up. Based on our findings and the known benefits of vitamin D repletion therapy for preventing falls and fracture, as well as the emerging benefits reported in studies of numerous other chronic
Acknowledgments
We thank Nicholas Emanuele, MD, Professor and Division Director, Division of Endocrinology & Metabolism, Department of Medicine, Loyola University Health System for his review of this manuscript and suggestions. There are no conflicts of interest to report.
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