Sarcopenia in Acute Ischemic Stroke

University Clinical Hospital na V.V.Vinogradov (branch of RUDN university na Patrice Lumumba)400 enrolled

Overview

The objective of this observational study is to determine the prevalence of sarcopenia in patients aged 50 years and older with acute ischemic stroke, to characterize its trajectory during the acute phase using instrumental verification and functional-cognitive assessments, and to evaluate its impact on functional outcome at three months. The main research question is: Is the presence of sarcopenia at admission associated with less favorable stroke outcomes, including higher rates of complications and mortality? Participants receiving standard medical care for acute ischemic stroke will undergo extended functional assessment for sarcopenia, and a subset will additionally undergo cognitive evaluation.

Study Type

OBSERVATIONAL

Enrollment

400

Conditions

Sarcopenia Acute Stroke

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 50 years and older * Acute ischemic stroke confirmed by CT or MRI * Admission within the first 72 hours * Written informed consent and availability of a contact telephone number for follow-up Exclusion Criteria: * TIA without a visible lesion on neuroimaging; bilateral hemiparesis * Amputations or severe contractures that preclude anthropometric assessment * Active cancer at stage IV or life expectancy of less than 3 months * Neuromuscular diseases; chronic use of systemic glucocorticoids for more than 3 months * Pregnancy; refusal to participate Discontinuation criteria (drop-out) * Discharge or death within the first 7 days * Withdrawal of consent * Transfer to another facility resulting in loss of contact

Outcomes

Primary Outcomes

Change from Baseline in Barthel Index for Activities of Daily Living at 14 days

Lower scores indicate increasing disability and a greater need for skilled care. Min - 0 ( \< 20 - totally dependent), max - 100 ( \> 80 - independent).

Time frame: Baseline and 14 days

Change from Baseline in Modified Rankin scale at 90 days

Min - 0 (no disability), max - 6 (dead). A score of 0 is no disability, 5 is disability requiring constant care for all needs; 6 is death.

Time frame: Baseline and 90 days

Secondary Outcomes

Number of Participants with sarcopenia

Time frame: Baseline

Change from Baseline in arm muscle mass at 14 and 28 days.

Mid-upper arm circumference: measured at the midpoint between the acromion and the olecranon with the arm relaxed (2 measurements) in cm. Arm muscle circumference and area are calculated using the Heymsfield formula.

Time frame: Baseline, 14 and 28 days

Change from Baseline in calf circumference at 14 and 28 days

Calf circumference: measured in the seated position, with the knee at a right angle, at the widest part of the non-paretic calf, with the tape snug but without compression (2 measurements) in cm. Calf circumference below 34 cm in men and 33 cm in women is classified as reduced.

Time frame: Baseline, 14 and 28 days

Change from Baseline in handgrip strength at 14 and 28 days.

Handgrip dynamometry: performed in the seated position with the elbow at a right angle; three trials on the non-paretic hand, with the mean value used for analysis. Handgrip strength of the non-paretic hand below 27 kg in men and 16 kg in women is classified as reduced.

Time frame: Baseline, 14 and 28 days.

Correlations between anthropometric measures and ultrasound/CT parameters

Time frame: Baseline, 14, 28, and 90 days

Change from Baseline in National Institutes of Health Stroke Scale (NIHSS) at 24 hours, 7 and 14 days.

Min - 0, max - 42. A higher score means a patients has more severe symptoms. Patients with a score of \<4 are highly likely to have good clinical outcomes.

Time frame: Baseline, 24 hours, 7 and 14 days.

Change from Baseline in Rivermead Mobility Index at 14 and 28 days.

Min - 0, max - 15. Higher scores indicate better mobility performance. A score of 0 indicates an inability to complete any of the 15 tasks.

Time frame: Baseline, 14 and 28 days.

Mortality at 14 and 90 days

Mortality rate at 14 and 90 days

Time frame: 14 and 90 days

Hospital length of stay

Days. Total number of days spent admitted to the hospital during the index hospital stay, calculated from admission date to final discharge date.

Time frame: Up to 28 days

Intensive care unit length of stay

Days. Total number of days spent in the intensive care unit from the time of initial ICU admission to successful transfer or discharge to a step-down unit.