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Vitamin D status and post sternotomy bone healing; a prospective radiologic observational study

Haci Ali Ucak, Hasan Uncu, Sennur Disli, Orsan Deniz Urgun, Ozge Ozcan Abacioglu, Osman Ciloglu, Dilek Ucak.




Abstract

Sternotomy is the most common incision technique used in cardiac surgery. Some complications due to this method, which requires a large bone incision, increase morbidity and mortality. Vitamin D deficiency is an important health problem that can be observed in all age groups in the society. In this study, we aimed to radiologically examine the relationship between vitamin D level and bone healing after sternotomy.120 patients who underwent sternotomy for coronary artery bypass surgery under elective conditions between 2019-2020 were included in our study. The patients were divided into 3 groups according to their pre-operative 25-hydroxyvitamin D levels, with 40 patients in each group. Bone healing was evaluated with computed tomography at 3 and 6 months following the operation.Preoperative demographic data, laboratory and clinical results, except for vitamin D levels, were similar in all patients. There was no significant difference between the groups in terms of clinical bone healing in the first 3 months. However, it was observed that bone healing was weaker in patients with low vitamin D on radiological imaging. On the 6th month images, it was found that the differences in the level of bone tissue healing decreased in all patient groups.Vitamin D is a steroid-structured vitamin that plays important roles in many physiological mechanisms, especially bone healing. The results of our study showed that; In coronary bypass operations performed by sternotomy, there is a significant relationship between bone healing and vitamin D level, especially in the first 3 months. Pre-operative detection of vitamin D deficiency may help reduce sternotomy-related complications, especially in patient groups in which additional risk factors such as obesity and diabetes mellitus are identified.

Key words: Vitamin D, sternotomy, osteotomy, coronary artery bypass, tomography






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