Acute Stroke, Sarcopenia
Conditions
Keywords
sarcopenia, acute stroke
Brief summary
The objective of this observational study is to determine the prevalence of sarcopenia in patients aged 50 years and older with acute ischemic stroke, to characterize its trajectory during the acute phase using instrumental verification and functional-cognitive assessments, and to evaluate its impact on functional outcome at three months. The main research question is: Is the presence of sarcopenia at admission associated with less favorable stroke outcomes, including higher rates of complications and mortality? Participants receiving standard medical care for acute ischemic stroke will undergo extended functional assessment for sarcopenia, and a subset will additionally undergo cognitive evaluation.
Interventions
None listed
Sponsors
University Clinical Hospital na V.V.Vinogradov (branch of RUDN university na Patrice Lumumba)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Inclusion criteria
* Age 50 years and older * Acute ischemic stroke confirmed by CT or MRI * Admission within the first 72 hours * Written informed consent and availability of a contact telephone number for follow-up
Exclusion criteria
* TIA without a visible lesion on neuroimaging; bilateral hemiparesis * Amputations or severe contractures that preclude anthropometric assessment * Active cancer at stage IV or life expectancy of less than 3 months * Neuromuscular diseases; chronic use of systemic glucocorticoids for more than 3 months * Pregnancy; refusal to participate Discontinuation criteria (drop-out) * Discharge or death within the first 7 days * Withdrawal of consent * Transfer to another facility resulting in loss of contact
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Barthel Index for Activities of Daily Living at 14 days | Baseline and 14 days | Lower scores indicate increasing disability and a greater need for skilled care. Min - 0 ( \< 20 - totally dependent), max - 100 ( \> 80 - independent). |
| Change from Baseline in Modified Rankin scale at 90 days | Baseline and 90 days | Min - 0 (no disability), max - 6 (dead). A score of 0 is no disability, 5 is disability requiring constant care for all needs; 6 is death. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants with sarcopenia | Baseline | — |
| Change from Baseline in arm muscle mass at 14 and 28 days. | Baseline, 14 and 28 days | Mid-upper arm circumference: measured at the midpoint between the acromion and the olecranon with the arm relaxed (2 measurements) in cm. Arm muscle circumference and area are calculated using the Heymsfield formula. |
| Change from Baseline in calf circumference at 14 and 28 days | Baseline, 14 and 28 days | Calf circumference: measured in the seated position, with the knee at a right angle, at the widest part of the non-paretic calf, with the tape snug but without compression (2 measurements) in cm. Calf circumference below 34 cm in men and 33 cm in women is classified as reduced. |
| Change from Baseline in handgrip strength at 14 and 28 days. | Baseline, 14 and 28 days. | Handgrip dynamometry: performed in the seated position with the elbow at a right angle; three trials on the non-paretic hand, with the mean value used for analysis. Handgrip strength of the non-paretic hand below 27 kg in men and 16 kg in women is classified as reduced. |
| Correlations between anthropometric measures and ultrasound/CT parameters | Baseline, 14, 28, and 90 days | — |
| Change from Baseline in National Institutes of Health Stroke Scale (NIHSS) at 24 hours, 7 and 14 days. | Baseline, 24 hours, 7 and 14 days. | Min - 0, max - 42. A higher score means a patients has more severe symptoms. Patients with a score of \<4 are highly likely to have good clinical outcomes. |
| Change from Baseline in Rivermead Mobility Index at 14 and 28 days. | Baseline, 14 and 28 days. | Min - 0, max - 15. Higher scores indicate better mobility performance. A score of 0 indicates an inability to complete any of the 15 tasks. |
| Mortality at 14 and 90 days | 14 and 90 days | Mortality rate at 14 and 90 days |
| Hospital length of stay | Up to 28 days | Days. Total number of days spent admitted to the hospital during the index hospital stay, calculated from admission date to final discharge date. |
| Intensive care unit length of stay | Up to 28 days | Days. Total number of days spent in the intensive care unit from the time of initial ICU admission to successful transfer or discharge to a step-down unit. |
| Number of Participants with recurrent events within 90 days | From baseline to 90 days | — |
Countries
Russia
Outcome results
None listed