The Impact of Sarcopenia on COPD Exacerbation Admission Outcome and Further Exacerbation Risk

Chronic obstructive pulmonary disease (COPD) is more prevalent and has more impact on health status because of progressive air pollution, tobacco smoking and aging society. The COPD prevalence investigation in 2013 by phone call showed at least 6% of the population with more than 40 years-old in Taiwan. It also was the 7th ranking of death causes in Taiwan then. Apart from chronic inflammation in lung and deteriorated lung function, it had extrapulmonary complications, such as cardiovascular problems, osteoporosis and muscle wasting. The concept of sarcopenia was proposed at first in 1989. It increases the risk of falls, disability and lowering life quality. Besides, it increased the mortality risk after admission from acute ward. Thereafter, sarcopenia is one of COPD co-morbidities, which should have great impacts of COPD. The studies showed sarcopenia reduced exercise capacities and worsening dyspnea scores. On the other hand, COPD exacerbation brings significant health burden. But there is limited data about the effect on sarcopenia on COPD exacerbation. We conducted a prospective observational study. We measured skeletal muscle mass and the strength of the used hand grip within 3 days of admission and before discharge. Mortality and exacerbation in one year are the primary end-points

Study Overview

• Status: Completed
• Conditions: Sarcopenia; COPD Exacerbation
• Intervention / Treatment: Diagnostic test: sarcopenia measurement

• Study Type: Observational
• Enrollment (Actual): 43

Contacts and Locations

Study Locations

• Taiwan
  • New Taipei, Taiwan, 220
    • Far Eastern Memorial Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients more than 45 years-old, were admitted due to COPD exacerbation.

Description

Inclusion criteria: Patients more than 45 years-old, were admitted due to COPD exacerbation.

COPD exacerbation criteria:

1. acute worsening respiratory symptoms without any other causes, And
2. Smoking more than 15 pack-years or the history of noxious gas exposure, And
3. Spirometry reports suggests obstructive ventilatory defect (FEV1/FVC <0.7) or
4. Attending physicians diagnose as COPD by clinical parameters if spirometry data are not available while enrolling.

Definite COPD exacerbation: fulfill 1、2、3 Probable COPD exacerbation: fulfill 1、2、4

Exclusion criteria:

1. Significant fluid retention such as edema, pleural effusion or ascites,
2. Patients with permanent pacemaker or implantable cardioverter defibrillator ,
3. Morbid obesity with BMI >34

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
COPD exacerbation	Diagnostic test: sarcopenia measurement; BIA for fat free muscle mass hand grasp strength

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Mortality and exacerbations within 1 year of admission	1 years

Collaborators and Investigators

• Sponsor: Far Eastern Memorial Hospital

Publications and helpful links

General Publications

• Lee CT, Wang PH. Handgrip strength during admission for COPD exacerbation: impact on further exacerbation risk. BMC Pulm Med. 2021 Jul 21;21(1):245. doi: 10.1186/s12890-021-01610-7.

Study record dates

Study Major Dates

• Study Start (Actual): January 31, 2018
• Primary Completion (Actual): January 31, 2019
• Study Completion (Actual): June 21, 2020

Study Registration Dates

• First Submitted: May 10, 2021
• First Submitted That Met QC Criteria: May 10, 2021
• First Posted (Actual): May 13, 2021

Study Record Updates

• Last Update Posted (Actual): May 13, 2021
• Last Update Submitted That Met QC Criteria: May 10, 2021
• Last Verified: May 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Respiratory Tract Diseases; Lung Diseases; Neurologic Manifestations; Neuromuscular Manifestations; Pathological Conditions, Anatomical; Lung Diseases, Obstructive; Muscular Atrophy; Atrophy; Pulmonary Disease, Chronic Obstructive; Sarcopenia
• Other Study ID Numbers: FEMH-106099-E

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: The data that support the findings of this study are available from the corresponding author, [P.H.W], upon reasonable request

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No