Ultrasound Assessment of Muscle to Quantify Frailty.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 111
- 试验地点
- 1
- 主要终点
- Surgical intensive care unit length of stay
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients admitted to the SICU (within 72 hours of admission)
- •Age over 18 years
- •Stay on the SICU for at least 24 hours
排除标准
- •Ongoing discussions about goals of care
- •Motor component of Glasgow Coma Scale <5
- •Unstable fractures
- •Preexisting paralysis
- •Pregnancy
- •Absence of both lower limbs
结局指标
主要结局
Surgical intensive care unit length of stay
时间窗: Patients will be followed until SICU discharge, an expected 2 days to 2 weeks.
Time from study inclusion to SICU discharge, an expected time of 2 days to 2 weeks.
次要结局
- Hospital length of stay(Patients will be followed until hospital discharge, an expected 4 days to 4 weeks)
- Discharge Disposition(Patient will be followed until hospital discharge, an expected 4 days to 4 weeks)
- Ventilator-free days(Patients will be followed until SICU discharge, an expected 2 days to 2 weeks.)
研究者
Matthias Eikermann
Director of Research, Critical Care Division, Associate Professor of Anesthesia, Harvard Medical School
Massachusetts General Hospital