Detection of Muscle Loss in Acute Stroke Patients Who Need Enteral Nutrition (MASS)
NCT ID: NCT03825419
Last Updated: 2022-04-27
Study Results
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Basic Information
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COMPLETED
125 participants
OBSERVATIONAL
2019-01-23
2021-11-30
Brief Summary
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Detailed Description
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Demographic data, stroke subtype, lesion localization, anthropometric measures will be recorded. Muscle in three different anatomical sites will be measured by CT following admission in patients included in the study.
For anthropometric measurements, height, body weight, body mass index, waist circumference, triceps skin thickness and calf circumference values will be used.
The muscle mass will be measured from the paraspinal muscles at the L3 vertebra level and from the muscles around the humerus and femur on the non-paralytic side of the extremities by CT.
All patients will receive standard enteral nutritional support with a standardized calorie and protein-based protocol recommended by international guidelines. The choice of the commercial enteral product will be left to the investigator, without any encouragement or restriction for use of any commercial product.
The enteral nutrition protocol will be implemented as follows;
* Nasogastric or nasojejunal access
* Continuous infusion
* Targeted daily calories - 25-30 kcal / kg
* Targeted daily protein - 1.2-1.5 gr / kg
* 20 ml / h initial infusion rate
* Increase infusion rate by 10-20 ml / h in 8-12 hours
* Targeted calorie-protein requirement will be reached at the end of 72 hours.
Patients will continue their routine follow-up in the neurology intensive care unit / stroke unit / neurology department. Daily enteral nutrition dose, complications attributed to enteral nutrition and systemic comorbidities will be recorded. Anthropometric measurements and muscle mass measurements with CT at three different locations will be repeated at the end of the second week (14 days ± 3 days) .
The study will evaluate whether or not muscle mass develops 14 days after acute ischemic stroke. The end points of the study is deterioration of anthropometric measurements and loss of muscle mass demonstrated by CT at follow up. The differences between patients with and without muscle loss will be assessed from the the aspects of demographic characteristics, ischemic stroke subtype, comorbidities and the success attained in reaching enteral nutritional goals.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Eligibility Criteria
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Inclusion Criteria
* Admission within first 24 hours after symptom onset
* Admission NIHSS score \> 8
* Being unable to walk
* Need for enteral tube feeding due to problems with consciousness or dysphagia
Exclusion Criteria
* Known muscle disease, neuropathy, neuromuscular junction disease
18 Years
ALL
No
Sponsors
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Abbott Nutrition
INDUSTRY
Klinar CRO
OTHER
Turkish Neurological Society
UNKNOWN
Turkish Stroke Research and Clinical Trials Network
NETWORK
Responsible Party
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Ethem Murat Arsava
Prof.Dr.
Locations
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Ankara University Faculty of Medicine
Ankara, , Turkey (Türkiye)
Gazi University Faculty Of Medicine
Ankara, , Turkey (Türkiye)
Hacettepe University Faculty of Medicine
Ankara, , Turkey (Türkiye)
Eskişehir Osmangazi Faculty of Medicine
Eskişehir, , Turkey (Türkiye)
Gaziantep University Faculty of Medicine
Gaziantep, , Turkey (Türkiye)
İstanbul Şişli Hamidiye Etfal Training and Research Hospital
Istanbul, , Turkey (Türkiye)
Dokuz Eylül University Faculty of Medicine
Izmir, , Turkey (Türkiye)
Ege University Faculty of Medicine
Izmir, , Turkey (Türkiye)
İzmir Katip Çelebi University Atatürk Training and Research Hospital
Izmir, , Turkey (Türkiye)
Ondokuz Mayıs University Faculty of Medicine
Samsun, , Turkey (Türkiye)
Countries
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References
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Shiraishi A, Yoshimura Y, Wakabayashi H, Tsuji Y. Prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients: Implications for oral sarcopenia. Clin Nutr. 2018 Feb;37(1):204-207. doi: 10.1016/j.clnu.2016.12.002. Epub 2016 Dec 10.
Scherbakov N, Sandek A, Doehner W. Stroke-related sarcopenia: specific characteristics. J Am Med Dir Assoc. 2015 Apr;16(4):272-6. doi: 10.1016/j.jamda.2014.12.007. Epub 2015 Feb 10.
Puthucheary ZA, Rawal J, McPhail M, Connolly B, Ratnayake G, Chan P, Hopkinson NS, Phadke R, Dew T, Sidhu PS, Velloso C, Seymour J, Agley CC, Selby A, Limb M, Edwards LM, Smith K, Rowlerson A, Rennie MJ, Moxham J, Harridge SD, Hart N, Montgomery HE. Acute skeletal muscle wasting in critical illness. JAMA. 2013 Oct 16;310(15):1591-600. doi: 10.1001/jama.2013.278481.
Coelen RJ, Wiggers JK, Nio CY, Besselink MG, Busch OR, Gouma DJ, van Gulik TM. Preoperative computed tomography assessment of skeletal muscle mass is valuable in predicting outcomes following hepatectomy for perihilar cholangiocarcinoma. HPB (Oxford). 2015 Jun;17(6):520-8. doi: 10.1111/hpb.12394. Epub 2015 Feb 28.
Gungor L, Arsava EM, Guler A, Togay Isikay C, Aykac O, Batur Caglayan HZ, Kozak HH, Aydingoz U, Topcuoglu MA; MASS investigators. Determinants of in-hospital muscle loss in acute ischemic stroke - Results of the Muscle Assessment in Stroke Study (MASS). Clin Nutr. 2023 Mar;42(3):431-439. doi: 10.1016/j.clnu.2023.01.017. Epub 2023 Feb 3.
Other Identifiers
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MASS
Identifier Type: -
Identifier Source: org_study_id
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