Biomarkers for Length of Hospital Stay and Loss of Muscle Mass and Function in Old Medical Patients (PROTECT)

Bispebjerg Hospital

Status: Completed

Conditions: Length of Stay; Muscle Loss; Sarcopenia

Treatments: Other: Development of a risk assessment tool based on clinical and functional measures and systemic biomarkers; Other: Development of a risk assessment tool for loss of muscle mass and physical function based on clinical and functional measures and systemic biomarkers

Study type: Observational

Funder types: Other

Identifiers

NCT04151108

H-19039214

Details and patient eligibility

About

As humans age, there is a gradual loss of skeletal muscle mass and strength, termed sarcopenia. The underlying causes of sarcopenia are yet not fully elucidated but are thought to be multifactorial and include increased levels of systemic pro-inflammatory mediators, a decrease in anabolic hormones and changes in the neuromuscular system. Furthermore, physical inactivity, chronic diseases, immobilisation and hospitalisation are known to play an important part in the development of sarcopenia.

The prevalence of sarcopenia ranges from 20-30% (aged >70yrs) within the general community. However, the prevalence of sarcopenia in geriatric patients after an acute hospital admission is substantially higher, estimated at ≈50%. Furthermore, successive events of hospitalisation have been suggested to contribute to the development of sarcopenia, as even short periods (4-5 days) of skeletal muscle disuse are known to induce muscle atrophy.

Mean length of hospital stay in geriatric wards due to acute illness or hip-fracture is typically 7 to 11 days during which the level of physical activity is strongly reduced leading to an accelerated loss of muscle mass that many older patients never recover from.

Notably, a substantial part of the deterioration in functional capacity could be avoided just by counteracting loss of muscle mass during hospitalization. As such, we need to identify sensitive biological, clinical and functional biomarkers predicting loss of muscle mass and function during hospitalization to identify patients at risk of developing sarcopenia. Additionally, it is crucial to investigate the association of these biomarkers with hospital length of stay, as hospitalisation has been suggested to contribute to the development of sarcopenia while longer hospital stays may increase patient risk of hospital-acquired infections and place an economic burden on society.

Enrollment: 1,072 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• equal to or over the age of 65
• admitted to the acute ward at Bispebjerg Hospital

Exclusion criteria

• age under 65 years
• terminal illness
• participants who do not understand Danish
• participants in isolation with airborne or droplet infections

Trial design

1,072 participants in 2 patient groups

Old medical patients

Description:

Blood tests, frailty (CSHA Frailty Scale), risk of pressure ulcers (Braden Score), handgrip strength, chair-rise test, Orientation-Memory-Concentration test (OMC), screening for sarcopenia (SARC-F), screening for malnutrition (SNAQ), body composition. Will be assessed at admission

Treatment:

Other: Development of a risk assessment tool based on clinical and functional measures and systemic biomarkers

Geriatric patients

Description:

Blood tests, frailty (CSHA Frailty Scale), risk of pressure ulcers (Braden Score), handgrip strength, chair-rise test, gait-speed, Orientation-Memory-Concentration test (OMC), screening for sarcopenia (SARC-F), screening for malnutrition (SNAQ), body composition. Blood tests, physical function measures and body composition will be assessed at both admission and discharge.

Treatment:

Other: Development of a risk assessment tool for loss of muscle mass and physical function based on clinical and functional measures and systemic biomarkers

Other: Development of a risk assessment tool based on clinical and functional measures and systemic biomarkers