The feasibility of conducting acute sarcopenia research in hospitalised older patients: a prospective cohort study

Carly Welch, Carolyn Greig, Zeinab Majid, Tahir Masud, Hannah Moorey, Thomas Pinkney, Thomas Jackson

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Abstract

PURPOSE: To assess feasibility of conducting acute sarcopenia research in complex populations of hospitalised older adults.

METHODS: Patients ≥ 70 years old were recruited to three cohorts: elective colorectal surgery, emergency (abdominal) surgery, medical patients with infections. Participants were recruited to the elective cohort in preoperative assessment clinic, and acutely admitted participants from surgical and medical wards at the Queen Elizabeth Hospital Birmingham. Serial measures of muscle quantity (ultrasound quadriceps, bioelectrical impedance analysis), muscle function (hand grip strength, physical performance), and questionnaires (mini-nutritional assessment, physical function) were performed at baseline, within 7 (± 2) days of admission/surgery, and 13 (± 1) weeks post-admission/surgery. Feasibility outcomes were assessed across timepoints including recruitment and drop-out rates, and procedure completion rates.

RESULTS: Eighty-one participants were recruited (mean age 79, 38.3% females). Recruitment rates were higher in elective (75%, 24/32) compared to emergency surgery (37.2%, 16/43), and medical participants (45.1%, 41/91; p = 0.003). Drop-out rates varied from 8.3 to 19.5% at 7 days, and 12.5-43.9% at 13 weeks. Age and gender did not differ between patients assessed for eligibility, approached, or recruited. Completion rates were highest for ultrasound quadriceps (98.8%, 80/81 across all groups at baseline). Gait speed completion rates were lower in medical (70.7%, 29/41) compared to elective participants (100%, 24/24) at baseline.

CONCLUSION: Higher participation refusal and drop-out rates should be expected for research involving recruitment of participants from the acute setting. Assessment of muscle quantity/quality through ultrasound is recommended in early-stage trials in the acute setting, where completion rates of physical performance testing are expected to be lower.

Original languageEnglish
JournalEuropean Geriatric Medicine
Early online date5 Oct 2021
DOIs
Publication statusE-pub ahead of print - 5 Oct 2021

Bibliographical note

Funding Information:
This research has been sponsored by and reviewed by the University of Birmingham research governance team. Ethical approval has been obtained from Wales Research Ethics Committee 4 (19/WA/0036), the Health Research Authority, and the University Hospitals Birmingham NHS Trust Research and Development department.

Funding Information:
This research was funded by a project grant from the Dowager Countess Eleanor Peel Trust and the Medical Research Council—Versus Arthritis Centre for Musculoskeletal Ageing Research awarded to Dr Carly Welch in the form of a PhD studentship. Dr Thomas Jackson is funded by the West Midlands National Institute for Health Research (NIHR) Clinical Research Network Research Scholar programme. The views in this manuscript are those of the authors and not necessarily those of the NIHR, the National Health Service, or the Department of Health. The funding bodies were not involved in the design of the study, collection, analysis, or interpretation of the data, or in writing the manuscript.

Keywords

  • Acute sarcopenia
  • Feasibility
  • Frailty
  • Ultrasound
  • Bioelectrical impedance analysis

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology

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