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.
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Öznur Demiroluk, MD
- Número de telefone: +905335229508
- E-mail: onrdemiroluk@hotmail.com
Locais de estudo
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Istanbul, Turquia (Türkiye), 34000
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital
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Contato:
- cansu ofluoğlu, MD
- Número de telefone: +905358640564
- E-mail: cansuakin.iu@gmail.com
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Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto mais velho
Aceita Voluntários Saudáveis
Método de amostragem
População do estudo
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Número de grupos/coortes
Coortes e Intervenções
Grupo / CoorteGrupo / Coorte |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
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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.
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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.
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O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Number of Participants With Prolonged Postoperative Hospital Stay
Prazo: From the date of surgery through discharge from the index hospitalization, assessed up to 30 days after surgery.
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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.
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From the date of surgery through discharge from the index hospitalization, assessed up to 30 days after surgery.
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Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Number of Participants With Surgical Site Infection
Prazo: From the date of surgery through 90 days after surgery
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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
Prazo: within 30 days after surgery
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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
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Number of Participants With 90-Day All-Cause Mortality
Prazo: Within 90 days after surgery
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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
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Manifestações Neurológicas
- Doenças do Sistema Nervoso
- Manifestações Neuromusculares
- Ferimentos e Lesões
- Processos Patológicos
- Distúrbios Nutricionais
- Condições Patológicas, Anatômicas
- Infecções
- Lesões nas pernas
- Fraturas, Osso
- Fraturas Femorais
- Lesões do quadril
- Atrofia Muscular
- Atrofia
- Infecção da ferida
- Condições Patológicas, Sinais e Sintomas
- Doenças Nutricionais e Metabólicas
- Sinais e sintomas
- Desnutrição
- Fraturas de quadril
- Sarcopenia
- Infecção de Ferida Cirúrgica
- Complicações pós-operatórias
Outros números de identificação do estudo
Outros números de identificação do estudo
- FSMTRH-GNRI
- 2026/07-41 (Outro identificador: University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital Scientific Research Ethics Committee)
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