High rates of hip fracture (HF) in long-term care (LTC) lead to increased hospitalization and greater risk of death. Supplementation of residents with vitamin D3 (vitD) has been recommended, but may be infrequently acted upon. Using a prospective cohort design, we explored use of vitD at doses ≥800 IU for hip fractures (HF) and for mortality among permanent LTC residents in Saskatchewan between 2008 and 2012, using provincial administrative health databases (N = 23178). We used stepwise backward regression with Cox proportional hazard multivariate analysis for time to first HF or to death upon entry into LTC (excluding the first three months), the association of daily vitD (determined during the first three months), age, sex, age*sex interaction, prior HF, osteoporosis diagnosis and Charlson Comormidity Score (CCS) was determined. Users of VitD were more likely older, women and those with previous HF. For HF, no significant impact of vitD or CCS was found. Models for mortality, stratified by sex, showed in women only, that vitD use resulted in a significant inverse association with time to death [HR (0.91(0.87-0.96)]; for men it was 0.94(0.88-1.01). The impact of VitD supplementation in LTC deserves further investigation, however, the mechanisms for its effect on mortality remain unclear.

中文翻译：

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萨斯喀彻温省长期护理院中髋部骨折和死亡率的预测指标：补充维生素D是否起作用？

长期护理（LTC）中高比例的髋部骨折（HF）导致住院率增加和死亡风险增加。建议向居民补充维生素D3（vitD），但可能不经常采取。使用前瞻性队列设计，我们使用省级行政卫生数据库（N = 23178）探讨了≥800IU剂量的vitD在萨斯喀彻温省的髋部骨折（HF）和永久LTC居民死亡率中的使用（N = 23178）。我们采用逐步向后回归和Cox比例风险多元分析，分析了第一次心衰或进入LTC时死亡的时间（不包括前三个月），每日vitD的相关性（在前三个月确定），年龄，性别，年龄*确定了性交，先前的HF，骨质疏松症的诊断和Charlson共病评分（CCS）。VitD的使用者更可能是年龄较大的妇女和以前患有心力衰竭的妇女。对于HF，未发现vitD或CCS的显着影响。按性别分层的死亡率模型仅在女性中显示，vitD的使用与死亡时间显着负相关[HR（0.91（0.87-0.96）]；男性为0.94（0.88-1.01）。 LTC中补充VitD的方法值得进一步研究，但是其对死亡率影响的机制仍不清楚。