Frailty, Sarcopenia
Conditions
Keywords
geriatric anesthesia, sarcopenia, ultrasonography, postoperative complications, quadriceps femoris
Brief summary
After obtaining ethical approval, 42 patients with American Society of Anesthesiologists (ASA) scores I-III who were scheduled for surgery under general anesthesia were included in our prospective study. Patients were monitored in the preoperative preparation room in the operating room and frailty was assessed using the FRAIL scale and sarcopenia was assessed using the STAR ratio. The thickness of the rectus femoris and vastus intermedius muscles of the patients was measured and recorded by ultrasonography. Thigh lengths were measured and recorded. Rectus Femoris/Thigh Length (RF/B), Vastus Intermedius/Thigh Length (VI/B), and Total Muscle Thickness/Thigh Length (T/B) were calculated and recorded. Patients were followed up according to the Modified Aldrete Score after surgery in the anesthesia recovery unit, and the time to reach 9-10 points was recorded, and the time to leave the recovery unit was recorded. Postoperatively, complications were followed up according to the Clavien-Dindo Classification, and discharge times from the hospital were recorded.
Detailed description
Frailty is a clinically identifiable state of heightened vulnerability resulting from age-related declines in physiological systems and functions, leading to impaired resilience to stressors. Frailty is highly prevalent among the elderly and is associated with an increased risk of falls, disability, hospitalization, and mortality. Magnetic resonance imaging (MRI) and computed tomography (CT) are considered the gold standard for sarcopenia diagnosisCT is also limited due to radiation exposure and similar logistical constraints. In contrast, ultrasonography (USG) is portable, cost-effective, and can be performed at the bedside without radiation exposure. Using high-frequency ultrasound probes, peripheral muscle tissues and their dimensions can be rapidly assessed.
Interventions
DEVICEultrasonography
Right thigh length (between the right femur greater trochanter and patella) was measured and recorded while the patients were lying supine. A linear transducer (Philips Affiniti 50, Philips Medical Systems, Seattle, WA, United States) was used for ultrasonographic measurements. The rectus femoris (RF) and vastus intermedius (VI) were visualized with the feather-touch technique after a generous amount of ultrasound gel was sprayed in the center of the right thigh, and the thickness of the muscles was determined and recorded using ultrasonography software. After these measurements, the rectus femoris-to-thigh length ratio (RF/B), vastus intermedius-to-thigh length ratio (VI/B), and total muscle thickness-to-thigh length ratio (T/B) were calculated and recorded.
Sponsors
Eskisehir Osmangazi University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* patients over 60 years of age who are undergoing colorectal malignancy surgery under general anesthesia * patients willing to participate in the study * Patients with ASA score I-III
Exclusion criteria
* Patients with Parkinson's disease, * Alzheimer's disease, * history of cerebrovascular events, * neuromuscular disease, * cognitive dysfunction, * severe liver disease, * severe heart disease, * impaired cooperation due to kidney disease, * emergency and trauma patients, * patients with bilateral lower extremity amputations
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| age | 1 year | years old |
| sex | 1 year | female, male |
| height | 1 year | meter |
| body weight | 1. year | kg |
| educational status | 1 year | primary school graduate, middle school graduate, high school graduate, university graduate |
| marital status | 1 year | married, single, widowed |
| ASA score | 1 year | American Society of Anesthesiologists' Classification (ASA 1,2,3,4,5) |
| rectus femoris muscle thickness | 1 year | cm |
| vastus intermedius(VI) thickness | 1 year | cm |
| rectus femoris-to-thigh length ratio | 1 year | ratio |
| vastus intermedius-thigh length ratio | 1 year | ratio |
| total muscle thickness to thigh length ratio | 1 year | ratio |
| frailty score | 1 year | 0-NORMAL, 1-2 PRE-FRAİL, 3-5 FRAİL |
| recovery time from anesthesia | 1 year | minutes |
| hospital discharge time | 1 year | days |
| Modified Clavien-Dindo Classification | 1 year | 1, 2, 3A, 3B, 4A, 4B, 5 |
Countries
Turkey (Türkiye)
Outcome results
None listed