Multimodal Assessment of Frailty in Acute Stroke Patients

NCT ID: NCT06031909

Last Updated: 2023-09-11

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

UNKNOWN

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-08-01

Study Completion Date

2024-10-31

Brief Summary

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The goal of this study is to investigate the influence of frailty on clinical and stroke characteristics, treatment and outcomes in patients with acute stroke.

The main questions it aims to answer are:

1. How prevalent is frailty in patients with stroke?
2. Which impairments (e.g. undernutrion, impaired mobility, laboratory markers) contribute to frailty?
3. Is the outcome of frail patients worse than those without?
4. Are in-hospital complications more frequent in frail patients than those without?

Detailed Description

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Stroke is one of the most common causes of disability and mortality worldwide. A recognized complication in stroke patients is frailty, which is associated with increased costs, poorer prognosis, and higher mortality rates. However, there is currently no uniform definition or diagnostic criteria for frailty in stroke patients, and there is a need for standardized frailty assessments in this patient population.

The aim of this study is to determine the prevalence of frailty in stroke patients at the Stroke Unit of the University Hospital Giessen and to analyze the associated characteristics and impacts on clinical outcomes. A multimodal frailty assessment will be conducted to capture a wide range of frailty features and investigate their significance. The study includes all stroke patients admitted to the certified stroke- unit of the University Hospital Giessen within a 3-month period. There are no inclusion criteria related to age, gender, or type of stroke.

The multimodal frailty assessment encompasses determining appropriate blood values (e.g., CRP, albumin), assessing muscle strength/mass through handheld dynamometry and sonographic muscle diameter, utilizing scores like the Clinical Frailty Scale (CFS) and the Groningen Frailty Indicator (GFI), evaluating nutritional status (BMI), collecting image-based frailty data (e.g., sarcopenia, cerebral white matter lesions, lacunar strokes, brain atrophy), and conducting suitable one-year follow-ups. Additionally, demographic and clinical data such as age, gender, type of stroke, and treatment details will be recorded.

The primary outcome is the prevalence of frailty among stroke patients. Secondary outcomes include the characteristics and impacts of frailty in stroke patients, including correlations between various frailty features and clinical outcomes such as length of hospital stay, mortality, and functional outcome.

Conditions

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Stroke Frailty

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Stroke patients

Stroke patients admitted to the certified stroke-unit of the Department of Neurology, University Hospital Giessen, Germany.

Multimodal frailty assessment

Intervention Type DIAGNOSTIC_TEST

Different domains are assessed during hospital stay, these include:

* Clinical scores: Clinical Frailty scale (CFS), Groningen Frailty index (GFI)
* Brain frailty: assessing white matter hyperintensieties, atrophy and lacunar strokes in initial brain imaging
* Laboratory values: laboratory Frailty index (FI-Lab), inflammatory markers
* Nutrition: Controlling nutritional status score (CONUT-score), body mass index, dysphagia assessment (FOIS)
* Mobility/strengths: de Morton Mobility Index (DEMMI), grip strenghts of non-paralytic arm via dynamometer, muscle mass estimated by sonographic measurement of the biceps brachii muscle and the rectus femoris muscle.

Interventions

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Multimodal frailty assessment

Different domains are assessed during hospital stay, these include:

* Clinical scores: Clinical Frailty scale (CFS), Groningen Frailty index (GFI)
* Brain frailty: assessing white matter hyperintensieties, atrophy and lacunar strokes in initial brain imaging
* Laboratory values: laboratory Frailty index (FI-Lab), inflammatory markers
* Nutrition: Controlling nutritional status score (CONUT-score), body mass index, dysphagia assessment (FOIS)
* Mobility/strengths: de Morton Mobility Index (DEMMI), grip strenghts of non-paralytic arm via dynamometer, muscle mass estimated by sonographic measurement of the biceps brachii muscle and the rectus femoris muscle.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* treated at the certified stroke-unit of the Dpt. of Neurology, University Hospital Giessen
* diagnosis of ischemic (including transient ischemic attack) or hemorrhagic stroke

Exclusion Criteria

* withdrawal of care within 24 hours after admission
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Giessen

OTHER

Sponsor Role lead

Responsible Party

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Stefan Gerner

Principal Investigator, Associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stefan Gerner, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Neurology, University Hospital Giessen/Germany

Thorsten Doeppner, MD

Role: STUDY_CHAIR

Department of Neurology, University Hospital Giessen/Germany

Hagen Huttner, MD, PhD

Role: STUDY_CHAIR

Department of Neurology, University Hospital Giessen/Germany

Locations

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Department of Neurology, University Hospital Giessen

Giessen, Hesse, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Stefan Gerner, MD

Role: CONTACT

+49-641/985-45301

Thorsten Doeppner, MD

Role: CONTACT

+49-641/985-45301

Facility Contacts

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Stefan Gerner, MD

Role: primary

Thorsten Doeppner, MD

Role: backup

References

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Giede-Jeppe A, Bobinger T, Gerner ST, Sembill JA, Sprugel MI, Beuscher VD, Lucking H, Hoelter P, Kuramatsu JB, Huttner HB. Neutrophil-to-Lymphocyte Ratio Is an Independent Predictor for In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage. Cerebrovasc Dis. 2017;44(1-2):26-34. doi: 10.1159/000468996. Epub 2017 Apr 19.

Reference Type BACKGROUND
PMID: 28419988 (View on PubMed)

Giede-Jeppe A, Reichl J, Sprugel MI, Lucking H, Hoelter P, Eyupoglu IY, Kuramatsu JB, Huttner HB, Gerner ST. Neutrophil-to-lymphocyte ratio as an independent predictor for unfavorable functional outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg. 2019 Feb 1;132(2):400-407. doi: 10.3171/2018.9.JNS181975. Print 2020 Feb 1.

Reference Type BACKGROUND
PMID: 30717052 (View on PubMed)

Gerner ST, Reichl J, Custal C, Brandner S, Eyupoglu IY, Lucking H, Holter P, Kallmunzer B, Huttner HB. Long-Term Complications and Influence on Outcome in Patients Surviving Spontaneous Subarachnoid Hemorrhage. Cerebrovasc Dis. 2020;49(3):307-315. doi: 10.1159/000508577. Epub 2020 Jul 3.

Reference Type BACKGROUND
PMID: 32623428 (View on PubMed)

Related Links

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https://www.ukgm.de/ugm_2/deu/ugi_neu/index.html

website of the recruiting site: Dpt. of Neurology, University Hospital Giessen

Other Identifiers

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AZ 220/21

Identifier Type: -

Identifier Source: org_study_id

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