EASE- Ultrasound

Funding: Alberta Innovates Health Solutions Partnerships for Research and Innovation in the Health System Grant (2014-2017)

Background: Seniors (age ≥ 65 years old) who have emergency surgery are at increased risk for sarcopenia (the gradual loss of muscle mass resulting in smaller and weaker muscles). From clinical observations, we suspect that admission to hospital represents a particularly high risk period for losing muscle mass and function. These losses may occur for several reasons, including the physical stress caused by the reason for hospitalization and the surgery and because many patients are unable to take in enough calories in hospital.

Previous retrospective research by our group has shown that abdominal computed tomography (CT) images showing sarcopenia was independently predictive of greater complication rates, discharge disposition, and in-hospital mortality in the very elderly (≥ 80 years old) emergency surgery population. Currently CT is the gold standard method for diagnosing sarcopenic patients, but getting patients to the radiology department, the high radiation exposure to the patients and high costs limits the use of it. Thigh ultrasound is an emerging, inexpensive and non-invasive technique being used to assess muscle mass in hospitalized patients.

Study Aim: First, to compare abdominal CT imaging with thigh ultrasound, to assess the consistency and validity across sarcopenic diagnostic tools. Second, to determine if thigh ultrasound identified sarcopenia is predictive of in-hospital complications and mortality, post-operative cognition, functional status, and quality of life.

Study Design: Prospective cohort sub-study of patients participating in the EASE study. Eligible participants will have thigh ultrasounds completed in hospital and post discharge to assess sarcopenia. Presence of sarcopenia will then be compared with their EASE study outcomes to assess its predictability of patient morbidity and mortality.

Importance: The use of thigh ultrasounds to assess sarcopenia is an emerging field. Combining clinical and patient reported outcomes with radiologically defined sarcopenia measurements will allow us to use sarcopenia as a predictor for outcomes in a greater subset of elderly surgical patients.

Locations: University of Alberta Hospital, Edmonton, Alberta.