| Effect of high-dosage cholecalciferol and extended physiotherapy on complications after hip fracture: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 20458090 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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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Authors:
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Heike A Bischoff-Ferrari; Bess Dawson-Hughes; Andreas Platz; Endel J Orav; Hannes B Stähelin; Walter C Willett; Uenal Can; Andreas Egli; Nicolas J Mueller; Silvan Looser; Beat Bretscher; Elisabeth Minder; Athanasios Vergopoulos; Robert Theiler |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of internal medicine Volume: 170 ISSN: 1538-3679 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-11 Completed Date: 2010-06-02 Revised Date: 2010-10-19 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 813-20 Citation Subset: AIM; IM |
Affiliation:
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Centre on Aging and Mobility, University of Zurich, University Hospital Zurich, Gloriastrasse 25, 8091 Zurich, Switzerland. Heike.Bischoff@usz.ch |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00133640 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Accidental Falls
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prevention & control Aged Aged, 80 and over Bone Density Conservation Agents / administration & dosage, pharmacology, therapeutic use* Cholecalciferol / administration & dosage, pharmacology, therapeutic use* Combined Modality Therapy Dose-Response Relationship, Drug Double-Blind Method Drug Toxicity Female Hip Fractures / therapy* Humans Male Multivariate Analysis Patient Readmission Physical Therapy Modalities* Poisson Distribution Recurrence Regression Analysis Switzerland |
| Chemical | |
Reg. No./Substance:
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0/Bone Density Conservation Agents; 67-97-0/Cholecalciferol |
| Comments/Corrections | |
Comment In:
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J Physiother. 2010;56(3):201
[PMID:
20795928
]
Evid Based Med. 2010 Oct;15(5):144-5 [PMID: 20651101 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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