Detection of Muscle Loss in Acute Stroke Patients Who Need Enteral Nutrition (MASS)

NCT ID: NCT03825419

Last Updated: 2022-04-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

125 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-01-23

Study Completion Date

2021-11-30

Brief Summary

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The degree of muscle loss over the course of inpatient stay will be evaluated in patients with a diagnosis of acute ischemic stroke admitted to Neurocritical Care Units and necessitating enteral nutrition.

Detailed Description

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This study is a multicenter, prospective observational study. The study period is 12 months. There are no investigational products to be followed or used in the study.

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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Acute Ischemic Stroke

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Acute ischemic stroke
* 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

* Retained ability for oral feeding
* Known muscle disease, neuropathy, neuromuscular junction disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Nutrition

INDUSTRY

Sponsor Role collaborator

Klinar CRO

OTHER

Sponsor Role collaborator

Turkish Neurological Society

UNKNOWN

Sponsor Role collaborator

Turkish Stroke Research and Clinical Trials Network

NETWORK

Sponsor Role lead

Responsible Party

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Ethem Murat Arsava

Prof.Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ankara University Faculty of Medicine

Ankara, , Turkey (Türkiye)

Site Status

Gazi University Faculty Of Medicine

Ankara, , Turkey (Türkiye)

Site Status

Hacettepe University Faculty of Medicine

Ankara, , Turkey (Türkiye)

Site Status

Eskişehir Osmangazi Faculty of Medicine

Eskişehir, , Turkey (Türkiye)

Site Status

Gaziantep University Faculty of Medicine

Gaziantep, , Turkey (Türkiye)

Site Status

İstanbul Şişli Hamidiye Etfal Training and Research Hospital

Istanbul, , Turkey (Türkiye)

Site Status

Dokuz Eylül University Faculty of Medicine

Izmir, , Turkey (Türkiye)

Site Status

Ege University Faculty of Medicine

Izmir, , Turkey (Türkiye)

Site Status

İzmir Katip Çelebi University Atatürk Training and Research Hospital

Izmir, , Turkey (Türkiye)

Site Status

Ondokuz Mayıs University Faculty of Medicine

Samsun, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

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.

Reference Type BACKGROUND
PMID: 28017450 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25676847 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 24108501 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25726722 (View on PubMed)

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.

Reference Type DERIVED
PMID: 36805095 (View on PubMed)

Other Identifiers

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MASS

Identifier Type: -

Identifier Source: org_study_id

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