The aim of the study is to identify the prevalence of malnutrition and sarcopenia in patients admitted in Swiss rehabilitation centers. Furthermore, the aim is to investigate the changes of selected malnutrition and sarcopenia parameters over the length of the rehabilitation stay.
The project aims to investigate the prevalence of malnutrition and sarcopenia in the rehabilitation setting. A cross-sectional national multicenter study will be conducted in five rehabilitation centers in Switzerland, including 80 - 130 participants per center for the primary objective (prevalence study). Patients will be screened for malnutrition and sarcopenia with established screening tools and if an elevated risk is observed, diagnosis will be confirmed and severity investigated according to international guidelines. Furthermore, the evolution of selected malnutrition and sarcopenia parameters over the rehabilitation stay should be assessed.
Study Type
OBSERVATIONAL
Enrollment
550
Klinik Barmelweid AG
Barmelweid, Switzerland
REHAB Basel
Basel, Switzerland
University Department of Geriatric Medicine FELIX PLATTER
Basel, Switzerland
Berner Reha Zentrum AG
Heiligenschwendi, Switzerland
Prevalence of malnutrition - Risk for malnutrition
The risk for malnutrition will be screened by the Nutritional Risk Screening (NRS-2002, in points). NRS has a scale from 0 to 7 points; higher points indicate a higher risk for malnutrition.
Time frame: Within 7 days after admission
Body weight
(in kg)
Time frame: Within 7 days after admission
Height
(in cm)
Time frame: Within 7 days after admission
Body Mass Index
(calculated by weight and height in kg/m2)
Time frame: Within 7 days after admission
Weight loss
Weight loss (in percent in six categories - \<5 percent within the last 6 months, 5-10 percent within the last 6 months, \>10 percent within the last 6 months; \<10 percent in more than 6 months, 10 -20 percent in more than 6 months, \>20 percent in more than 6 months)
Time frame: Within 7 days after admission
Reduced energy intake
Reduced energy intake (in percent of intake versus requirement in three categories: less than 50 percent of energy requirement covered for more than 1 week, any reduced energy intake versus requirement for \>2 weeks, no reduced energy intake)
Time frame: Within 7 days after admission
Muscle mass by Bioelectrical Impedance Analysis (BIA) - Part 1
Resistance (in Ohm) and Reactance (in Ohm)
Time frame: Within 7 days after admission
Muscle mass by Bioelectrical Impedance Analysis (BIA) - Part 2
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Zürcher RehaZentren - Klinik Wald
Wald, Switzerland
Resistance (in Ohm) and Reactance (in Ohm) measured with BIA are combined with further information on weight, height, sex and age to calculate the appendicular skeletal muscle mass index (in kg/m2)
Time frame: Within 7 days after admission
Prevalence of malnutrition - Confirmed diagnosis and severity of malnutrition
In case of positive screening, diagnosis of malnutrition will be confirmed and severity assessed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria using the following measures described above: weight (in kg); height (in cm); Body Mass Index (calculated by weight and height in kg/m2); weight loss (in percent in six categories - \<5 percent within the last 6 months, 5-10 percent within the last 6 months, \>10 percent within the last 6 months; \<10 percent in more than 6 months, 10 -20 percent in more than 6 months, \>20 percent in more than 6 months); reduced energy intake (in percent of intake versus requirement in three categories: less than 50 percent of energy requirement covered for more than 1 week, any reduced energy intake versus requirement for \>2 weeks, no reduced energy intake); Bioelectrical impedance analysis for muscle mass: resistance (in Ohm), reactance (in Ohm), Appendicular skeletal muscle mass index (in kg/m2)
Time frame: Within 7 days after admission
Prevalence of malnutrition - overall
Overall prevalence of malnutrition will be reported in percent
Time frame: Calculated through study completion after five months recruitment duration
Prevalence of sarcopenia - Risk for sarcopenia by SARC-F
according to European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Screening will be performed by the Strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire (in points). SARC-F has a scale from 0 - 10 with higher score indicating higher risk for sarcopenia.
Time frame: Within 7 days after admission
Prevalence of sarcopenia - Risk for sarcopenia by handgrip strength
according to European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Screening will be performed by handgrip strength (in kPa)
Time frame: Within 7 days after admission
Prevalence of sarcopenia - Risk for sarcopenia
according to European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Screening will be performed by Chair Stand Test (in seconds)
Time frame: Within 7 days after admission
Prevalence of sarcopenia - Diagnosis of sarcopenia
In case of positive screening, muscle mass will be measured by BIA via resistance (in Ohm), reactance (in Ohm). Resistance (in Ohm) and Reactance (in Ohm) measured by BIA is combined with further information on weight, height, sex and age to calculate the appendicular skeletal muscle mass index in kg/m2. Diagnosis is confirmed if the appendicular skeletal muscle mass index is below a threshold (\<7.0 kg/m2 for male and \< 5.5. kg/m2 for female).
Time frame: Within 7 days after admission
Prevalence of sarcopenia - Severity of sarcopenia
In case of positive screening, severity of sarcopenia will be analysed by Timed Up and Go Test (in seconds).
Time frame: Within 7 days after admission
Prevalence of sarcopenia - Overall
Overall prevalence of sarcopenia will be reported in percent
Time frame: Calculated through study completion after five months recruitment duration
Changes of handgrip strength between admission and discharge of rehabilitation
Handgrip strength (in kPa)
Time frame: At admission and 21 days after admission (or, if admission occurs before 21 days and the length of stay was at least 14 days than within 3 days before discharge)
Changes of body weight between admission and discharge of rehabilitation
body weight (in kg)
Time frame: At admission and 21 days after admission (or, if admission occurs before 21 days and the length of stay was at least 14 days than within 3 days before discharge)
Changes of BMI between admission and discharge of rehabilitation
BMI (calculated in kg/m2)
Time frame: At admission and 21 days after admission (or, if admission occurs before 21 days and the length of stay was at least 14 days than within 3 days before discharge)
Changes of Functional Independence Measure between admission and discharge of rehabilitation
Functional Independence Measure (FIM) (in points). FIM has a scale from 18 to 126 points. Higher points indicate a higher independence for activities of daily living.
Time frame: At admission and 21 days after admission (or, if admission occurs before 21 days and the length of stay was at least 14 days than within 3 days before discharge)