25-Hydroxyvitamin D Levels and Vitamin D3 Supplementation During Postacute Spinal Cord Injury Rehabilitation.

Abstract

Background: Insufficient 25-hydroxyvitamin D [25(OH)D] levels are associated with falls, fractures, and worse overall health outcomes. We evaluated 25(OH)D levels in individuals with spinal cord injury or disorder (SCI/D) during postacute rehabilitation who received vitamin D3 supplementation according to routine clinical practice. Associations with clinical outcomes were also assessed.

Methods: This prospective observational cohort study included individuals aged 18 to 85 years with newly acquired SCI/D admitted for inpatient rehabilitation to a specialized center. The following parameters were collected monthly from admission to discharge as part of the clinical routine: serum 25(OH)D, vitamin D3 supplementation, pressure injuries, bed rest, and falls. 25(OH)D levels were categorized as insufficient (≤75 nmol/L) or sufficient (>75 nmol/L). Descriptive statistics and group comparisons were performed.

Results: Eighty-seven patients (25 [29%] females, median age 53 [IQR 39-67] years) were included and followed for 186 (163-205) days. The proportion of patients with a sufficient 25(OH)D level increased from 8% (95% CI, 3-16) to 61% (95% CI, 50-71) (p < .001). Ninety-two percent of patients received vitamin D3 (1100 [1000-2000] IU/day). No differences in 25(OH)D levels or supplementation doses were found for the occurrence of pressure injuries, bed rest, or falls.

Conclusion: This is the first study to examine 25(OH)D levels and vitamin D3 supplementation during postacute SCI/D rehabilitation. Insufficient 25(OH)D levels were prevalent throughout rehabilitation. For some patients, the doses of vitamin D3 used in current clinical practice may be too low to achieve sufficient 25(OH)D levels. Regular monitoring of 25(OH)D levels and individualized supplementation strategies are warranted.