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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Old medical patients | 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 |
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| Geriatric patients | 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. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Development of a risk assessment tool based on clinical and functional measures and systemic biomarkers | Other | Blood tests, frailty (CSHA Clinical Frailty Scale) and risk of pressure ulcers (Braden Score), Early Warning Score (EWS), sarcopenia (SARC-F), malnutrition (SNAQ), cognitive status, comorbidity (Charlson comorbidity Index), polypharmacy, muscle strength, and body composition (BIA) |
| Measure | Description | Time Frame |
|---|---|---|
| Length of stay | Hours of admission from index to discharge | From date of hospital admission until discharge, assessed up to 2 months |
| Change in muscle mass | Relative change in muscle mass during hospitalization | Change from baseline muscle mass, assessed at admission, to muscle mass assessed at discharge, an average of 10 days |
| Change in muscle strength | Change in handgrip strength during hospitalization | Change from baseline muscle strength, assessed at admission, to muscle strength assessed at discharge, an average of 10 days |
| Change in physical function | Change in chair-rise and gait-speed ability during hospitalization | Change from baseline physical function, assessed at admission, to physical function assessed at discharge, an average of 10 days |
| Measure | Description | Time Frame |
|---|---|---|
| Readmission | Time to readmission from discharge | Time to readmission 90 days from discharge |
| Mortality | Time to mortality from index admission |
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Inclusion Criteria:
Exclusion Criteria:
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The study population will consist of participants admitted to the acute ward and the geriatric ward at Bispebjerg Hospital
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| Name | Affiliation | Role |
|---|---|---|
| Charlotte Suetta, Professor | Geriatric Research Unit, Bispebjerg Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bispebjerg Hospital | Copenhagen | 2400 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33376179 | Derived | Kamper RS, Schultz M, Hansen SK, Andersen H, Ekmann A, Nygaard H, Helland F, Wejse MR, Rahbek CB, Noerst T, Pressel E, Nielsen FE, Suetta C. Biomarkers for length of hospital stay, changes in muscle mass, strength and physical function in older medical patients: protocol for the Copenhagen PROTECT study-a prospective cohort study. BMJ Open. 2020 Dec 29;10(12):e042786. doi: 10.1136/bmjopen-2020-042786. |
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The following will be available: Study Protocol and Statistical Analysis Plan (SAP).
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Feb 26, 2020 |
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Plasma and serum
|
| Development of a risk assessment tool for loss of muscle mass and physical function based on clinical and functional measures and systemic biomarkers | Other | Blood tests, frailty (CSHA Clinical Frailty Scale), Early Warning Score (EWS), cognitive status, sarcopenia (SARC-f), malnutrition (SNAQ), comorbidity (Charlson comorbidity Index), polypharmacy, physical function, physical performance, and body composition (BIA) |
|
| Time to mortality 90 days from index admission |
| Feb 26, 2020 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| D055948 | Sarcopenia |
| D009133 | Muscular Atrophy |
| ID | Term |
|---|---|
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012816 | Signs and Symptoms |
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