Effects of Frailty, Sarcopenia and Muscle Wasting on Outcomes of Patients in the Surgical Intensive Care Unit
| Status: | Completed |
|---|---|
| Conditions: | Hospital, Neurology, Orthopedic |
| Therapuetic Areas: | Neurology, Orthopedics / Podiatry, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/1/2017 |
| Start Date: | May 2014 |
| End Date: | December 2015 |
Ultrasound Assessment of Muscle to Quantify Frailty.
The primary aim of the study is to evaluate consequences of frailty in critically ill
patients. We hypothesize that a higher frailty index (based on published questionnaires)
predicts a longer surgical intensive care unit and hospital length of stay, less
ventilator-free days and a higher likelihood of an adverse discharge disposition.
Our secondary aim is to identify muscle-size derived variables that can be used to predict
frailty. We hypothesize that a low skeletal muscle mass measured by ultrasound can be used to
quantify frailty, and to also predict the outcome of SICU patients, expressed as longer stay
in the surgical intensive care unit and longer stay in the hospital, less ventilator-free
days and a higher likelihood of an adverse discharge disposition.
Our third aim is to examine potential triggers of muscle wasting in critically ill patients.
Muscle wasting will be assessed by repetitive ultrasound measurements of muscle mass. We
hypothesize that a significant decrease in skeletal muscle mass predicts longer stay at the
surgical intensive care unit and longer hospital length of stay, less ventilator-free days
and adverse discharge disposition.
patients. We hypothesize that a higher frailty index (based on published questionnaires)
predicts a longer surgical intensive care unit and hospital length of stay, less
ventilator-free days and a higher likelihood of an adverse discharge disposition.
Our secondary aim is to identify muscle-size derived variables that can be used to predict
frailty. We hypothesize that a low skeletal muscle mass measured by ultrasound can be used to
quantify frailty, and to also predict the outcome of SICU patients, expressed as longer stay
in the surgical intensive care unit and longer stay in the hospital, less ventilator-free
days and a higher likelihood of an adverse discharge disposition.
Our third aim is to examine potential triggers of muscle wasting in critically ill patients.
Muscle wasting will be assessed by repetitive ultrasound measurements of muscle mass. We
hypothesize that a significant decrease in skeletal muscle mass predicts longer stay at the
surgical intensive care unit and longer hospital length of stay, less ventilator-free days
and adverse discharge disposition.
Frailty is defined as status of decreased physiological reserve which leads to a higher
vulnerability to stressors. It is associated with a higher risk of morbidity and mortality.
Within the geriatric population, frailty is common and a known predictor of adverse outcomes.
The usefulness of a frailty assessment as an outcome measure in critically ill patients of
all ages needs to be evaluated. This study evaluates whether frailty has an effect on outcome
of critically ill patients.
Muscle weakness predicts outcome of ICU patients but is hard to determine in the ICU since
the measurement is volition dependent. Muscle mass correlates with muscle weakness and can be
assessed objectively. This study evaluates the consequences of reduced muscle mass or
sarcopenia on the outcome of critically ill patients.
In addition, muscle wasting in the ICU may predict persistent functional disability. This
study aims to examine muscle wasting of critically ill patients on the surgical ICU.
vulnerability to stressors. It is associated with a higher risk of morbidity and mortality.
Within the geriatric population, frailty is common and a known predictor of adverse outcomes.
The usefulness of a frailty assessment as an outcome measure in critically ill patients of
all ages needs to be evaluated. This study evaluates whether frailty has an effect on outcome
of critically ill patients.
Muscle weakness predicts outcome of ICU patients but is hard to determine in the ICU since
the measurement is volition dependent. Muscle mass correlates with muscle weakness and can be
assessed objectively. This study evaluates the consequences of reduced muscle mass or
sarcopenia on the outcome of critically ill patients.
In addition, muscle wasting in the ICU may predict persistent functional disability. This
study aims to examine muscle wasting of critically ill patients on the surgical ICU.
Inclusion Criteria:
- Patients admitted to the SICU (within 72 hours of admission)
- Age over 18 years
- Stay on the SICU for at least 24 hours
Exclusion Criteria:
- Ongoing discussions about goals of care
- Motor component of Glasgow Coma Scale <5
- Unstable fractures
- Preexisting paralysis
- Pregnancy
- Absence of both lower limbs
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