Cachexia; Cancer; Sarcopenia, Cancer, Hospitalizations, Sarcopenia
Conditions
Keywords
Hand Grip Strength, Prognosis, Hospitalized Cancer Patients, Cachexia, Malnutrition, Functional Decline, Mortality
Brief summary
This prospective observational cohort study aims to evaluate whether integrated bedside assessment of handgrip strength, cachexia-related indices, body composition, and patient-reported outcomes improves short-term prognostic stratification in hospitalized patients with metastatic cancer. Handgrip strength is a simple, rapid, and non-invasive measure of muscle function and physical reserve, and it is increasingly recognized as an indicator of frailty, sarcopenia, nutritional status, and cancer cachexia. In addition to handgrip strength, this study evaluates the prognostic value of the handgrip strength-cachexia index, bioelectrical impedance analysis-derived body composition parameters, the CRP-triglyceride-glucose index, and validated patient-reported outcome measures. The study will examine whether these admission-time assessments are associated with 30-day all-cause mortality, 90-day all-cause mortality, and 30-day unplanned hospital readmission.
Detailed description
Handgrip strength declines with age and is associated with frailty, sarcopenia, cancer cachexia, nutritional deterioration, and adverse clinical outcomes in patients with cancer. In this prospective observational cohort study, consecutive adult patients with histologically or cytologically confirmed metastatic solid malignancies undergoing unplanned hospitalization will be assessed at the time of admission. Handgrip strength will be measured within the first 48 hours of admission using a calibrated hydraulic hand dynamometer. Measurements will be performed on the dominant hand, with patients seated, the elbow flexed at 90 degrees, and the wrist in a neutral position, according to standardized procedures. Three consecutive measurements will be obtained, and the highest value will be recorded for analysis. In addition to handgrip strength, admission-time assessments will include routine laboratory parameters, the handgrip strength-cachexia index, the CRP-triglyceride-glucose index, bioelectrical impedance analysis-derived body composition measures, and validated patient-reported outcome instruments, including SARC-F, FACT-G, PSQI, PG-SGA, visual analogue scale pain score, and visual analogue scale appetite score. Patients will be followed for short-term clinical outcomes, including 30-day all-cause mortality, 90-day all-cause mortality, and 30-day unplanned hospital readmission after index discharge.
Interventions
Hand grip strength will be measured within the first 24 hours of hospitalization using a calibrated hand dynamometer. Measurements will be performed on the dominant hand, with patients seated, following standardized international procedures. Three consecutive measurements will be obtained, and the average value will be recorded. The test is non-invasive, quick, and performed by oncology clinicians trained in the protocol.
Sponsors
Ankara Etlik City Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years and older * Pathologically confirmed diagnosis of cancer * Hospitalized with an expected hospital stay of more than 48 hours * Ability to provide written informed consent
Exclusion criteria
* Diagnosis of anorexia nervosa * Acute pancreatitis or acute liver failure at admission * History of gastric bypass surgery * Presence of chronic active infections * History of solid organ transplantation * Pregnant or breastfeeding women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 30-day All-Cause Mortality | 30 days after hospital admission | All-cause mortality within 30 days of hospital admission among cancer patients (Yes/No). Mortality status will be assessed through hospital records and follow-up. Hand grip strength values will be analyzed in relation to mortality risk. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intensive Care Unit Admission | 30 days after hospital admission | Number of patients requiring ICU admission within 30 days of hospital admission (Yes/No). |
| Hospital Readmission | 30 days after discharge | All-cause hospital readmission within 30 days of discharge (Yes/No). |
| Functional Decline - ECOG Performance Status | Baseline and 30 days after hospital admission | Decline in functional status assessed by the Eastern Cooperative Oncology Group (ECOG) Performance Status (range 0-4; 0 = fully active, 1 = restricted in strenuous activity, 2 = ambulatory but unable to work, 3 = limited self-care, 4 = completely disabled; higher score = worse performance), comparing baseline and 30-day follow-up. |
| Length of Hospital Stay | Through initial hospitalization, up to 30 days | Duration of initial hospitalization, measured in days from admission to discharge. |
| Major Complications | 30 days after hospital admission | Incidence of major complications including hospital-acquired infection, respiratory failure, cardiovascular events, acute renal failure, or gastrointestinal failure within 30 days (Yes/No). |
| Functional Decline - Patient-Generated Subjective Global Assessment (PG-SGA) | Baseline and 30 days after hospital admission | Decline in nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) Score (range 0-35; 0-1 = no intervention required, 2-3 = patient/family education, 4-8 = requires dietitian intervention, ≥9 = critical need for nutritional intervention and/or symptom management; higher score = worse nutritional status), comparing baseline and 30-day follow-up. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORGalip Can Uyar, MD
Ankara Etlik City Hospital
Outcome results
None listed