Prevalence of an insufficient vitamin D status at the onset of a spinal cord injury – a cross-sectional study

Study design: A cross-sectional study. Objective: This study aimed to investigate the vitamin D status after acute spinal cord injury (SCI) onset. Setting: Specialized SCI rehabilitation center in Switzerland. Methods: Patients admitted to the center after an acute SCI onset were included. The prevalence of a deficient (25(OH)D ≤ 50 nmol/l), insufficient (50 < 25(OH)D ≤ 75 nmol/l) and sufficient (25(OH)D > 75 nmol/l) vitamin D status were determined after admission. Vitamin D status was compared between different patient groups based on demographic and SCI characteristics. The occurrence of bed rest, falls and pressure injuries were also assessed. Results: In total, 87 patients (median (interquartile range); 53 (39–67) years, 25 females, 66 traumatic SCI, 54 paraplegia) were included. Assessed a median of 15 (9–22) days after SCI onset, median vitamin D status was 41 (26–57) (range 8–155) nmol/l. The majority of patients had a deficient (67%, 95% confidence interval (95% CI) 0.56–0.76) or insufficient (25%, 95% CI 0.17–0.36) vitamin D status. A moderate negative correlation was found between vitamin D status and body mass index (p= 0.003). A moderate positive correlation was found between vitamin D and calcium status (p= 0.01). Conclusion: A deficient or insufficient vitamin D status directly after SCI onset is highly prevalent. Vitamin D status should be carefully observed during acute SCI rehabilitation. We recommend that all patients with recent SCI onset should receive vitamin D supplementation with a dosage depending on their actual vitamin D status.