Clinical trial NCT06932224: This Study Aims to Measure the Effect of Acute Hospitalisation on the Physical and Cognitive Functioning of Older Orthopaedic Patients (Aged 65 or Above).
Official title: Hospital-associated Deconditioning: Exploring Factors Contributing to the Physical and Cognitive Decline of Older Adults During Hospitalisation
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Deconditioning
Orthopedic Fractures
Hospital Associated Deconditioning
Orthopaedic Injuries
Keywords: Hospital acquired deconditioning
Hospital associated deconditioning
Physical functioning
Cognitive functioning
Orthopaedic
Older patient
Older adults (65 years and older)
Muscle strength
Muscle mass
Lead sponsor: University of Southampton
Sponsor class: OTHER
First posted: 2025-04-17
Enrollment: 70
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Older adults admitted to SGH with an acute orthopaedic condition/injury.

Hospital staff who work at SGH who work with older orthopaedic inpatients.

Brief summary: This study aims to investigate the impact of hospitalisation on physical and cognitive performance in patients aged 65 and older admitted with an orthopaedic injury. This will be achieved by asking patients to participate in a series of physical and cognitive performance questionnaires and tests. These questionnaires and tests will be performed by the patients as close to their admission as possible and then again at day 7 of hospitalisation (or discharge if earlier) and at 4-6 weeks after discharge. However, if a patient's hospital stay lasts more than 30 days, they will be asked to take part in the interim data collection timepoint.

To summarize, patients will be assessed at least 3 times, 4 if your hospital stay is longer than 30 days. The first and second assessments will be in the hospital, and the third will be 4-6 weeks after discharge at you home (or where is appropriate). Additionally, patients will be asked to wear an activity watch between the first and second assessment.

The study will also explore patients experiences of their hospital stay and opinions on deconditioning, including the views and opinions of hospital staff. This information will be gathered by having interviews with a sample of the patients who took part in the questionnaires and tests and by having interviews with hospital staff. The interview will be conducted by the main researcher, Thomas Cartledge, and will take place either over the phone, online or in-person, depending on your preference. The interviews will be audio and/or video recorded, however the recordings will be deleted immediately once transcription is completed. The duration of the interview will last approximately 30-60 mins.


Eligibility criteria: Patient criteria:

Inclusion:

* Older adults aged 65 years or older
* Able to provide written consent
* Admitted to Southampton General Hospital (SGH) for an acute orthopaedic condition
* Been admitted to SGH \<72 hours before recruitment

Exclusion:

* Older adults who are not able to safely complete the quantitative measurement tools, as advised by the patient's clinician
* Patients receiving end of life care
* Require a hoist to transfer from bed to chair prior to hospitalisation
* Been admitted to SGH \>72 hours before recruitment
* Unable to consent

Hospital staff criteria:

Inclusion:

* Work at SGH
* Work with older orthopaedic inpatients
* Be able to provide written consent

Primary outcomes:
measure: Muscle strength measured via a hand held dynamometer.
timeFrame: From enrolment to the last data collection point at 4-6 weeks post discharge
measure: Muscle mass measured via Bioelectrical Impedance Analysis.
timeFrame: From enrolment to the last data collection point at 4-6 weeks post discharge.
measure: Sarcopenia risk assessed via the SARC-F questionnaire.
timeFrame: From enrolment to the last data collection point at 4-6 weeks post discharge.
measure: Functional mobility measured via the Short Physical Performance Battery (SPPB) questionnaire.
timeFrame: 4-6 weeks (discharge to the final data collection point).
measure: Health-related quality of life measured by the EQ-5D questionnaire.
timeFrame: From enrolment to the last data collection point at 4-6 weeks post discharge.
measure: Physical function measured via the Barthel Index questionnaire.
timeFrame: From enrolment to the last data collection point at 4-6 weeks post discharge.
measure: Cognitive impairment measured via The Montreal Cognitive Assessment (MoCA) score.
timeFrame: From enrolment to the last data collection point at 4-6 weeks post discharge.
measure: Delirium measured via the 4AT score.
timeFrame: From enrolment to the last data collection point at 4-6 weeks post discharge.
Secondary outcomes:
measure: Hospital re-admission rate
timeFrame: 3 months
measure: Hospital re-admission rate
timeFrame: 6 months
Other outcomes:
measure: Perceptions and attitudes towards hospital-associated deconditioning measured via semi-structured interviews.
timeFrame: Time frame for patients will be their last hospital admission (approx 7 days long) and staff will be asked to recall information from their last 2 months of work.
measure: Exploring practical ways of preventing hospital-associated deconditioning via semi-structed interviews.
timeFrame: Time frame for patients will be their last hospital admission (approx 7 days long) and staff will be asked to recall information from their last 2 months of work.
measure: Exploring barriers and facilitators to physical and cognitive risk factors of hospital-associated deconditioning via semi-structed interviews.
timeFrame: Time frame for patients will be their last hospital admission (approx 7 days long) and staff will be asked to recall information from their last 2 months of work.
Locations:
city: Southampton
country: United Kingdom
facility: University Hospitals Southampton Foundation Trust
state: Hampshire
Study officials:
References: