Determinants of in-hospital muscle loss in acute ischemic stroke- Results of the Muscle Assessment in Stroke Study (MASS)

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dc.contributor.authorGungor, Levent
dc.contributor.authorArsava, Ethem Murat
dc.contributor.authorGuler, Ayse
dc.contributor.authorIsikay, Canan Togay
dc.contributor.authorAykac, Ozlem
dc.contributor.authorCaglayan, Hale Zeynep Batur
dc.contributor.authorKozak, Hasan Huseyin
dc.date.accessioned2024-02-23T14:02:30Z
dc.date.available2024-02-23T14:02:30Z
dc.date.issued2023
dc.departmentNEÜen_US
dc.description.abstractBackground & aims: There is a change in the mass and composition of paretic and non-paretic skeletal muscles in the chronic phase of stroke. The multi-center, prospective, and observational Muscle Assessment in Stroke Study (MASS) was performed to evaluate the degree of muscle loss during the in-hospital acute stroke setting and determine factors contributing to this loss.Methods: Acute dysphagic ischemic stroke patients (n = 107) admitted to neuro-intensive care units were evaluated by computed tomography on days 1 and 14 after admission to determine the cross-sectional muscle area (CSMA) at the level of the mid-humerus, mid-thigh, and third lumbar vertebra. The percentage change in CSMA and variables associated with this change were evaluated by univariate and multivariate analyses.Results: There were significant reductions in CSMA in all the muscle groups analyzed; the most prom-inent change was observed in the arms (both: 14.2 +/- 10.7%; paretic: 17.7 +/- 11.6%; non-paretic: 10.1 +/- 12.5%), followed by the muscles in the legs (both: 12.4 +/- 8.7%; paretic: 12.9 +/- 9.9%; non-paretic: 12.0 +/- 9.3%) and L3-vertebra level (5.6 +/- 9.8%) (P < 0.001 for all). Higher calorie (r =-0.378, P < 0.001) or protein (r =-0.352, P < 0.001) intake was negatively associated with the decrease in CSMA of upper extremities. A substantial protein (>= 0.4 g/kg/d) or calorie (>= 5 kcal/kg/d) gap between targeted or actual intake was related to a larger decrease in CSMA in all the anatomic regions (P < 0.05 for all). Other significant predictors of muscle loss included history of diabetes mellitus, male sex, higher BMI, in-hospital infections, and the necessity for invasive mechanical ventilation.Conclusions: There is a considerable degree of loss in the global muscle mass in acute ischemic stroke patients over a two-week period. Along with several factors, falling significantly behind the daily protein or calorie targets was related to the decrease in the muscle area. Trial registration information: clinicaltrials.gov identifier NCT03825419.(c) 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.en_US
dc.description.sponsorshipTurkish Neurological Societyen_US
dc.description.sponsorshipThis study was supported by the Turkish Neurological Society and through an unrestricted research grant from Abbott.en_US
dc.identifier.doi10.1016/j.clnu.2023.01.017
dc.identifier.endpage439en_US
dc.identifier.issn0261-5614
dc.identifier.issn1532-1983
dc.identifier.issue3en_US
dc.identifier.pmid36805095en_US
dc.identifier.scopus2-s2.0-85148052289en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage431en_US
dc.identifier.urihttps://doi.org/10.1016/j.clnu.2023.01.017
dc.identifier.urihttps://hdl.handle.net/20.500.12452/11739
dc.identifier.volume42en_US
dc.identifier.wosWOS:000943626600001en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherChurchill Livingstoneen_US
dc.relation.ispartofClinical Nutritionen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectStrokeen_US
dc.subjectComputed Tomographyen_US
dc.subjectMuscle Massen_US
dc.subjectNutritional Gapen_US
dc.subjectNeuro-Intensive Careen_US
dc.titleDeterminants of in-hospital muscle loss in acute ischemic stroke- Results of the Muscle Assessment in Stroke Study (MASS)en_US
dc.typeArticleen_US

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