274Vitamin D Deficiency and Resource Utilisation – A Prospective Association

Abstract

Background: Hospital admissions and Emergency Department (ED) attendances are significant issues facing health services, accounting for a large proportion of healthcare costs and expenditure. They can also have significant implications for an individual with associated increased morbidity and mortality. The importance of identifying older people at risk and potentially modifiable risk factors is well recognised. The aim of this study is to prospectively evaluate the relationship between serum 25-hydroxyvitamin D (25(OH) D) and resource utilisation in older adults. Methods: Older adults participating in the TUDA study were included in this analysis. Details relating to hospitalisation and ED attendance were accessed through local computerised patient record systems. Information was gathered from date of TUDA participation until June 2013 and included; length of stay (LOS) and reason for admission. Results: Of the 3,093 participants, 1,577 participants attended the ED and 1,269 participants were admitted over the 3.6year follow-up period. ED attenders were older (79.2 v 73.7 years); less educated (11.3 v 12.6years), more frail; Timed Up and Go (TUG) at 17.8 v 15.4 seconds and had lower serum 25(OH)D levels than non-attenders, 59.1 v 70.6nmol/L. Those admitted were older (80.0 versus 74.1years) and had lower mean Vitamin D levels at 58.4nmol/L versus 69.3nmol/L than those not admitted. Adjusted Cox proportional hazard models, with Vitamin D as a categorical variable, showed those with Vitamin D levels <25nmol/L, compared with >25nmol/L, were more likely to be admitted, HR 0.80 p = 0.0063. Similar results were found for ED attendances, those participants deficient in Vitamin D (<25nmol/L) were more likely to attend the ED, HR 0.78 p = 0.001. Conclusions: Our study suggests an association between Vitamin D deficiency and poorer outcomes, including ED attendance and admission. As Vitamin D deficiency is a potentially modifiable factor, further studies including randomised control trials (RCTs) would be beneficial to further evaluate.