Femur Fractures, Frailty, Sarcopenia
Conditions
Keywords
Geriatric Anesthesia, Frailty, Hip Fracture, Sarcopenia, Rectus Femoris
Brief summary
This study aims to evaluate the frailty status of elderly patients undergoing surgery for hip fractures (femur trochanteric fractures). Since frailty is a critical factor in surgical outcomes and recovery, researchers want to find simple, fast, and objective ways to measure it. This study will investigate muscle thickness measured by ultrasound, handgrip strength measured by a dynamometer, and routine blood test values can accurately predict a patient's frailty level. If these objective methods are proven effective, it will help anesthesia and surgical teams manage the perioperative process more safely for high-risk elderly patients
Detailed description
65 and over years old elderly patients admitted to the orthopedics department with a diagnosis of trochanteric femur fracture will be enrolled in this study. Preoperative Assessment: A researcher anesthesiologist, who is not involved in the patient's perioperative clinical management, will conduct the assessments to ensure objectivity. One day prior to the scheduled surgery, the following procedures will be performed: Frailty Evaluation: Clinical frailty status will be determined using the Clinical Frailty Scale. In conjunction with this, handgrip strength will be measured using a calibrated hand dynamometer. Ultrasonographic Measurements: Ultrasound will be used to measure the thickness of the rectus femoris muscle and the distance from the femur to the skin. These measurements will serve as objective indicators of musculoskeletal status. Data Collection: Demographic data (age, weight, height, comorbidities) and routine preoperative laboratory results will be recorded from the hospital's electronic medical records. Laboratory parameters to be analyzed include: Hematological: Hemoglobin, MPV, MCV, Neutrophil, and Lymphocyte counts. Biochemical: Albumin, Creatinine, CRP, and GFR. The study focuses on evaluating the correlation between these objective measurements (ultrasound and dynamometry) and the established clinical frailty scores to determine their predictive value in the geriatric surgical population.
Interventions
Assessment of frailty status using the Clinical Frailty Scale and measurement of handgrip strength using a hand dynamometer (measured in kilograms). Ultrasonographic measurement of the rectus femoris muscle thickness (mm) and femur-skin distance (mm) conducted one day before surgery.
OTHERRectus femoris thickness measurement
By using ultrasound linear prob the thickness of rectus femoris muscle will be measured
Sponsors
ali ihsan uysal
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged 65 years and older. * Confirmed diagnosis of trochanteric femur fracture. * Planned for orthopedic surgery under general or regional anesthesia. * Ability to provide written informed consent (either by the patient or a legal representative).
Exclusion criteria
* Patients with advanced dementia or severe cognitive impairment who cannot cooperate with the handgrip strength test or Fried criteria questionnaire. * Patients with terminal-stage diseases or those under palliative care. * History of neuromuscular diseases or severe muscle-wasting conditions that affect the lower limbs (e.g., advanced muscular dystrophy). * Patients with active infections or skin lesions at the site of ultrasound measurement (rectus femoris area). * Emergency cases requiring immediate surgery where preoperative assessment cannot be completed.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between Rectus Femoris Muscle Thickness and Frailty Score | Preoperative (within 24 hours before surgery) | Evaluation of the relationship between clinical frailty status (measured by the Clinical Frailty Scale) and objective muscle mass (measured as rectus femoris thickness in millimeters via ultrasonography). Over 5 point indicate frailty. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Predictive Value of Handgrip Strength for Frailty | Preoperative | Assessment of handgrip strength using a hand dynamometer to evaluate its correlation with the Frailty Score. |
| Correlation of Laboratory Biomarkers with Frailty Status | 1 day before operation | Evaluation of the relationship between frailty and preoperative blood levels of Albumin, C-Reactive Protein (CRP), Glomerular Filtration Rate (GFR) |
| Hematological Indicators of Frailty | 1 day before operation | Analysis of Hemoglobin levels and Neutrophil-to-Lymphocyte Ratio (NLR) in relation to the patient's frailty score. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactAli İhsan Uysal, Ass.Prof
Outcome results
None listed