Prevalence of vitamin D deficiency in a multi-speciality hospital orthopaedic outpatient clinic

S. Chockalingam^a,*, S Ramkumar^b

^aSenior Consultant – Orthopaedic Surgeon, Kauvery Hospital, Trichy

^bOrthopaedic Surgeon, Kauvery Hospital, Salem

Objective

To assess the prevalence of Vitamin D deficiency and toxicity in a general Orthopaedic set up and the benefits of treatment.

Aim is also to highlight the importance of this condition in patients presenting without fractures

Materials And Methods

Study period 2009-2013
Total Outpatients at the institution: 270080
Total ortho outpatients at the Institution: 9521
Patients were analyzed for clinical features and laboratory evidence of Vitamin D deficiency.
Analysis of vitamin D3 levels using chemiluminescent immunoassays (CLIA) method.

Severity	Levels (ng/dl)
Deficient	<9.99
Insufficient	10-24.99
Optimal	25-80
Toxic	>80

Clinical Features

(a) Generalized bone pain

(b) General lethargy or tiredness

(d) Thoracic back pain

(e) Elderly immobile patients such as Severe OA

A total of 1373 from 9521 PTS were treated.

Vitamin D Test

Laboratory confirmed Vitamin D deficiency
Total in hospital 347
Ortho 298 Non-Ortho 49

Tested individuals

Results

14.42 % of patients were suspected to be Vitamin D deficient based on clinical features and lab. measures.
3.64 % of patients were found to be deficient by laboratory measures from 9521

Demographics of the vitamin d deficiency confirmed

Males:Females – 69:278 (19.89:80.11%)

347 – Total vitamin D lab.

298 – Vitamin D lab from ortho.

Discussion

Reduced Cost, increased awareness and testing

Limitations

The true prevalence of patients presenting to our institution for Ortho Consultation is not known

Subjective clinical features were used for treatment largely due to economic reasons [ cost of investigation]

Laboratory confirmation has its limitations

Conclusion

There is a very high incidence of vitamin D deficiency in tested individuals.

A large percentage of patients with Vitamin D deficiency were picked up in Ortho Outpatients

It affects all age groups

The peak incidence in between 41 to 70 yrs

Females outnumber males with Vitamin D deficiency 4:1 ratio

Reduction in cost of the test has resulted in more number of patients tested over the period of years

Prevalence of vitamin D deficiency in a multi-speciality hospital orthopaedic outpatient clinic