Prevalence of 25-Hydroxyvitamin D Deficiency in the Outpatient Rehabilitation Population

Pellicane AJ, Wysocki NM, Schnitzer TJ: Prevalence of 25-hydroxyvitamin D deficiency in the outpatient rehabilitation population. Am J Phys Med Rehabil 2010;89:899-904. Objective: To assess the prevalence of 25-hydroxyvitamin D insufficiency and deficiency in the outpatient rehabilitation setting and to identify patient characteristics associated with low serum 25-hydroxyvitamin D levels. Design: 25-Hydroxyvitamin D levels from 136 rehabilitation outpatients at an academic rehabilitation facility obtained from April 2007 to December 2008 for patient care purposes were captured via retrospective electronic medical record review. Results: Considering only those subjects not receiving 25-hydroxyvitamin D supplementation at time of evaluation, 33.0% were 25-hydroxyvitamin D Sufficient while 53.2% were Insufficient and 13.8% Deficient. Those outpatient subjects receiving supplementation at time of evaluation had significantly higher 25-hydroxyvitamin D levels compared with those not receiving supplementation (34.1 +/- 14.2 ng/ml vs. 25.9 +/- 15.2 ng/ml; P = 0.005). Blacks had significantly lower 25-hydroxyvitamin D levels compared with whites (18.0 +/- 10.6 ng/ml vs. 31.3 +/- 14.3 ng/ml; P < 0.001). Subjects not on vitamin D supplementation assigned to diagnostic groups, Spinal Cord Injury, Brain Injury, and Hereditary Musculoskeletal, all had average 25-hydroxyvitamin D levels well below the lower limit of Sufficiency. Conclusions: Sixty-seven percent of rehabilitation outpatients are 25-hydroxyvitamin D Insufficient or Deficient. Supplementation significantly affects 25-hydroxyvitamin D levels in the outpatient rehabilitation population. Non-white race and history of Spinal Cord Injury, Brain Injury, or Hereditary Musculoskeletal diagnosis seem to be associated with lower 25-hydroxyvitamin D levels.