GNRI and Rectus Femoris Muscle Thickness in Older Patients Undergoing Hip Fracture Surgery
Prognostic Value of the Geriatric Nutritional Risk Index and Ultrasonographic Rectus Femoris Muscle Thickness in Older Patients Undergoing Hip Fracture Surgery: A Prospective Observational Study
This prospective observational study will evaluate whether nutritional risk and reduced muscle mass are associated with postoperative outcomes in adults aged 65 years or older undergoing surgery for hip fracture.
Nutritional risk will be assessed using the Geriatric Nutritional Risk Index (GNRI), which is calculated from routine preoperative serum albumin, body weight, and ideal body weight. Rectus femoris muscle thickness will be measured before surgery using a brief, noninvasive ultrasound examination of the non-fractured thigh.
Participants will receive routine clinical care, and no treatment or anesthesia method will be assigned by the study. Clinical information will be collected from hospital records, including postoperative length of hospital stay, surgical site infection, and mortality. Survival status will be evaluated at 30 and 90 days after surgery using hospital records and/or telephone follow-up.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
This is a single-center, prospective observational cohort study involving consecutive patients aged 65 years or older who are scheduled to undergo surgical treatment for hip fracture at Fatih Sultan Mehmet Training and Research Hospital. The study will investigate the prognostic value of the Geriatric Nutritional Risk Index (GNRI) and ultrasonographic rectus femoris muscle thickness (RF-MT) for postoperative clinical outcomes.
After informed consent is obtained, demographic and preoperative clinical data will be recorded, including age, sex, height, weight, body mass index, comorbidities, American Society of Anesthesiologists physical status, fracture type, serum albumin, hemoglobin, C-reactive protein, and creatinine.
The GNRI will be calculated using the following formula:
GNRI = [1.489 × serum albumin (g/L)] + [41.7 × current body weight/ideal body weight].
When the ratio of current body weight to ideal body weight is greater than 1, the ratio will be set to 1. Participants will be classified according to the original GNRI categories: no nutritional risk (GNRI greater than 98), low nutritional risk (GNRI 92 to 98), and moderate or severe nutritional risk (GNRI less than 92).
Rectus femoris muscle thickness will be measured preoperatively on the non-fractured side using a high-frequency linear ultrasound probe. The measurement will be performed with the participant in the supine position at the midpoint between the anterior superior iliac spine and the upper border of the patella. Minimal probe pressure will be applied to avoid muscle compression. After the rectus femoris muscle is visualized in the transverse plane, muscle thickness will be measured as the greatest vertical distance between the superficial and deep fascia. Three measurements will be obtained, and their mean value will be used for analysis. All measurements will be performed by the same investigator experienced in ultrasonography.
Perioperative and postoperative data will include surgical procedure, anesthesia technique, duration of surgery, estimated blood loss, blood transfusion, intensive care unit admission, postoperative hospital length of stay, surgical site infection, and all-cause mortality at 30 and 90 days.
Postoperative hospital length of stay will be calculated as the number of days between surgery and hospital discharge. Prolonged postoperative hospital stay will be defined as a stay exceeding the 75th percentile of postoperative length of stay in the completed study cohort. Surgical site infections will be evaluated according to the Centers for Disease Control and Prevention criteria. Mortality status will be determined from hospital records and/or telephone follow-up.
No study-specific medication, anesthesia technique, surgical treatment, or additional blood sampling will be administered. The only study-specific procedure will be the noninvasive preoperative ultrasound measurement. Associations between GNRI, RF-MT, and postoperative outcomes will be evaluated using multivariable regression and receiver operating characteristic curve analyses.
研究の種類
研究の種類
入学 (推定)
入学
連絡先と場所
研究連絡先
研究連絡先
- 名前：Öznur Demiroluk, MD
- 電話番号：+905335229508
- メール：onrdemiroluk@hotmail.com
研究場所
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-
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Istanbul、トルコ（Türkiye）、34000
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital
-
コンタクト：
- cansu ofluoğlu, MD
- 電話番号：+905358640564
- メール：cansuakin.iu@gmail.com
-
-
参加基準
適格基準
適格基準
就学可能な年齢
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Age 65 years or older
- Scheduled to undergo surgical treatment for hip fracture
- Provision of informed consent by the participant or, when applicable, a legally authorized representative
Exclusion Criteria:
- Pathological fracture or fracture related to malignancy
- Advanced neuromuscular disease
- Active infection
- Planned revision surgery
- Lower limb amputation or severe deformity preventing rectus femoris muscle thickness measurement
- Inability to obtain informed consent from the participant or a legally authorized representative
研究計画
研究はどのように設計されていますか？
デザインの詳細
グループ/コホートの数
コホートと介入
グループ/コホートグループ/コホート |
介入・治療介入・治療 |
|---|---|
|
Geriatric Hip Fracture Cohort
Patients aged 65 years or older undergoing surgical treatment for hip fracture.
Preoperative nutritional risk will be assessed using the Geriatric Nutritional Risk Index, and rectus femoris muscle thickness will be measured by ultrasound on the non-fractured side.
Participants will receive routine clinical care, and no treatment, anesthesia technique, or surgical intervention will be assigned by the study.
|
Preoperative nutritional risk will be assessed using the Geriatric Nutritional Risk Index (GNRI), calculated from routine serum albumin, current body weight, and ideal body weight.
Participants will be categorized as having no nutritional risk (GNRI greater than 98), low nutritional risk (GNRI 92 to 98), or moderate/severe nutritional risk (GNRI less than 92).
The assessment will not alter routine clinical care.
|
この研究は何を測定していますか？
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Number of Participants With Prolonged Postoperative Hospital Stay
時間枠：From the date of surgery through discharge from the index hospitalization, assessed up to 30 days after surgery.
|
Postoperative hospital length of stay will be calculated as the number of days from the date of surgery to the date of discharge.
Prolonged postoperative hospital stay will be defined as a length of stay exceeding the 75th percentile of the postoperative length-of-stay distribution in the completed study cohort.
The outcome will be reported as the number and percentage of participants meeting this criterion.
|
From the date of surgery through discharge from the index hospitalization, assessed up to 30 days after surgery.
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Number of Participants With Surgical Site Infection
時間枠：From the date of surgery through 90 days after surgery
|
Surgical site infection will be assessed according to the Centers for Disease Control and Prevention criteria.
Superficial and deep incisional infections will be identified using clinical findings, microbiological culture results, radiological findings, and/or a clinical diagnosis made by an infectious diseases or orthopedic specialist.
The outcome will be reported as the number and percentage of participants with a surgical site infection.
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From the date of surgery through 90 days after surgery
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|
Number of Participants With 30-Day All-Cause Mortality
時間枠：within 30 days after surgery
|
Vital status will be determined using hospital records and/or telephone follow-up.
The outcome will be reported as the number and percentage of participants who die from any cause within 30 days after surgery.
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within 30 days after surgery
|
|
Number of Participants With 90-Day All-Cause Mortality
時間枠：Within 90 days after surgery
|
Vital status will be determined using hospital records and/or telephone follow-up.
The outcome will be reported as the number and percentage of participants who die from any cause within 90 days after surgery.
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Within 90 days after surgery
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- FSMTRH-GNRI
- 2026/07-41 (その他の識別子：University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital Scientific Research Ethics Committee)
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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