Hypovitaminosis D in acute inpatient cancer rehabilitation: Prevalence, predictors, and practical implications.

Abstract

Hypovitaminosis D is associated with adverse health outcomes, including increased mortality in patients with cancer. Although vitamin D insufficiency (23%-72%) and deficiency (20%-71%) are common among patients admitted to inpatient rehabilitation, their prevalence and predictors in cancer-specific inpatient rehabilitation populations remain uncharacterized. To determine the prevalence of hypovitaminosis D in adults with cancer admitted to acute inpatient rehabilitation and to identify demographic, clinical, laboratory, and functional predictors. Retrospective observational cohort study. An inpatient rehabilitation service within a tertiary cancer hospital. Consecutive adults with a cancer diagnosis admitted for acute inpatient rehabilitation between December 1, 2023, and May 24, 2024. Not applicable. The primary outcome was the prevalence of hypovitaminosis D (25-hydroxyvitamin D ≤ 29 ng/mL). Secondary outcomes included predictors of hypovitaminosis D and evaluation of the timing and frequency of vitamin D supplementation upon index hospital admission, upon admission to inpatient rehabilitation, and at 3 and 6 months post discharge. Of 126 patients, 78 (62%) had hypovitaminosis D. Significant predictors included relatively younger age (median 66.0 vs 71.5 years; effect size, 5.5 with 95% confidence interval [CI], 1.60-9.40, p = .006) and presence of neurogenic bladder or bowel (16.7% vs 2.4%; odds ratio, 0.12 with 95% CI, 0.003-0.924, p = .019). At hospital admission, 29% (n = 36) were receiving supplementation, and 40% (n = 51) initiated supplementation during inpatient rehabilitation. At 3 and 6 months post discharge, 48% (n = 61) and 39% (n = 49), respectively, had records of continued supplementation. Vitamin D supplementation was generally well tolerated during inpatient rehabilitation, with only minor side effects that were managed in three patients. Hypovitaminosis D was highly prevalent among adult patients with cancer undergoing inpatient rehabilitation. Identified predictors, including relatively younger age and neurogenic bladder or bowel, may help guide targeted screening.