Sarcopenia
Conditions
Keywords
Acute sarcopenia, muscle, physical function, older adults
Brief summary
This study aims to characterise acute changes in muscle mass, strength, physical performance in hospitalised older adults. We will assess the impact of these changes upon physical function at three month follow-up, and assess for the impact of clinical and immune-endocrine factors upon these changes.
Detailed description
Study Design Time-limited cohort study involving serial measurements of Bilateral Anterior Thigh Thickness (BATT) using ultrasound, handgrip strength, physical performance, and physical function measured using the Patient Reported Outcome Measures Information System (PROMIS®). We aim to fully characterise changes in these patients, and will perform a comprehensive evaluation of clinical factors including nutrition and physical activity, and measure immune-endocrine markers of inflammation. Study Participants Elective colorectal surgery, emergency abdominal surgery, and medical patients aged 70 years and older Planned Size of recruitment target 56 elective colorectal patients, 56 emergency abdominal surgery patients, and 56 medical patients with acute infections Follow up duration 3 months Primary research question Does acute change in quadriceps muscle thickness, handgrip strength and/or physical performance within one week of hospitalisation predict change in patient reported physical function at three months?
Interventions
PROCEDUREColorectal surgery procedure
Elective admission for colorectal surgery
PROCEDUREEmergency abdominal surgery
Emergency admission necessitating emergency surgery
DRUGAntibiotics
Treatment for infection and reason for admission
Sponsors
Dowager Countess Eleanor Peel Trust
University Hospital Birmingham NHS Foundation Trust
MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research
University of Birmingham
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Prospective cohort study
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
ELECTIVE COHORT * Aged 70 years or older at time of recruitment * Expected to undergo an elective major colorectal surgery procedure EMERGENCY SURGERY COHORT * Aged 70 years or older at time of recruitment * Emergency admission * Expected to undergo emergency abdominal procedure during admission, or emergency abdominal procedure performed within previous 48 hours MEDICAL COHORT * Aged 70 years or older at time of recruitment * Emergency admission for acute bacterial infection or presumed acute bacterial infection
Exclusion criteria
ELECTIVE COHORT * Unable to provide written informed consent at time of recruitment * Unable to understand verbal English * Life expectancy less than 30 days EMERGENCY SURGERY COHORT * Unable to provide written informed consent at time of recruitment and no consultee available * Unable to understand verbal English * Life expectancy less than 30 days MEDICAL COHORT * Unable to provide written informed consent at time of recruitment and no consultee available * Unable to understand verbal English * Life expectancy less than 30 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Physical function | Three months | Change in physical function at three months as measured by the T score derived from the Patient Reported Outcome Measures Information System (PROMIS®) - Item Bank v. 2.0, Physical Function, Short Form 10b. This is a patient-reported outcome measure of physical function. Raw scores are collected out of a maximum of 50; minimum of 10. These are converted to T scores, which are used for analysis (mean 50, SD 10; range 13.8 - 61.3). Higher scores are representative of better physical function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Bilateral Anterior Thigh Thickness (BATT) | Three months | Change in BATT (elective and emergency cohorts) |
| Handgrip strength | Three months | Change in handgrip strength (elective and emergency cohorts) |
| Acute changes during hospitalisation - gait speed | One week | Change in gait speed within one week of hospitalisation (elective and emergency cohorts) |
| Acute changes during hospitalisation - BATT | One week | Change in BATT within one week of hospitalisation (elective and emergency cohorts) |
| Acute changes during hospitalisation - handgrip strength | One week | Change in handgrip strength within one week of hospitalisation (elective and emergency cohorts) |
| Rectus femoris echogenicity (quantified using ImageJ software) | Immediately postoperatively, one week postoperatively, and at three months | Change in rectus femoris echogenicity (elective and emergency cohorts) |
| BATT: subcutaneous tissue ratio (BATT-SCR) | Immediately postoperatively and one week postoperatively | Change in BATT: subcutaneous tissue ratio (BATT-SCR) (elective and emergency cohorts) |
| Short Physical Performance Battery (SPPB) | Three months | Change in Short Physical Performance Battery (SPPB) score at (elective cohort) |
| Physical activity - steps taken | One week | Postoperative physical activity (steps taken) as measured by physical activity recorders (subset of elective and emergency cohorts) |
| Physical activity - distance walked | One week | Postoperative physical activity (distance walked) as measured by physical activity recorders (subset of elective and emergency cohorts) |
| Sedentary time | One week | Postoperative sedentary time as measured by physical activity recorders (subset of elective and emergency cohorts) |
| Acceptability (objective) - refusal | Three months | Participant refusal rates (elective and emergency cohorts) |
| Acceptability (objective) - missing data | Three months | Missing data (elective and emergency cohorts) |
| Acceptability (objective) - drop-outs | Three months | Drop-out rates (elective and emergency cohorts) |
| Acceptability (patient-reported) | Three months | Total derived acceptability score as measured by questionnaire upon study completion (elective and emergency cohorts) |
| Acute sarcopenia | One week postoperatively | Incidence of acute sarcopenia (elective and emergency cohorts) |
Countries
United Kingdom
Contacts
Primary ContactCarly Welch, MBChB
Outcome results
None listed