The Impact of Preoperative Nutrition Intervention on Muscle Mass Preserve in Older Adults Undergoing Elective Surgery

NCT07262034 | Not Yet Recruiting DMC

• 1 other identifier: 655/2568 (IRB2)
• Study Type: observational
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

Sarcopenia-the progressive loss of muscle mass and strength-is a major clinical issue, especially in surgical patients with malignancy. It's strongly linked to poor postoperative outcomes like increased complications, longer hospital stays, and higher mortality. Surgical stress (trauma, fasting, immobilization) significantly worsens this muscle catabolism. Consequently, early identification and targeted preoperative intervention are essential. Preoperative nutrition, part of a prehabilitation program, is a key strategy known to attenuate muscle loss and improve recovery. The Skeletal Muscle Index (SMI) is an objective metric used for risk stratification. The Siriraj Integrated Preoperative and Prehabilitation Center (SiPAP) uses a multidisciplinary model with nutritional counseling, but lacks routine sarcopenia screening or objective SMI measurement. Therefore, the impact of their specific nutritional interventions on preserving muscle mass remains unevaluated. Hypothesis: The structured, individualized preoperative nutritional intervention delivered by SiPAP to intraabdominal oncology patients will result in a net preservation or positive change in the Skeletal Muscle Index (SMI) over the preoperative period.

Conditions

Nutrition Status

Keywords

Preoperative; Sarcopenia; Body Composition Analyzer (BIA); Skeletal Muscle Index (SMI)

Outcome Measures

Primary Outcomes (1)

• Change from Baseline in the skeletal muscle index (SMI) at a day admit to surgery

  Skeletal muscle index (SMI) determined by bioelectrical impedance analysis (BIA) and report as a value with units of kilograms per meter squared (kg/m2)

  From a preoperative clinic consultation (baseline) to a day admit to surgery, up to 3 months

Secondary Outcomes (5)

• Change from Baseline in nutrition status at a day admit to surgery

  From a preoperative clinic consultation (baseline) to a day admit to surgery, up to 3 months

• Change from Baseline in sarcopenia classification at a day admit to surgery

  From a preoperative clinic consultation (baseline) to a day admit to surgery, up to 3 months

• Change from Baseline in the body weight at a day admit to surgery

  From a preoperative clinic consultation (baseline) to a day admit to surgery, up to 3 months

• Change from Baseline in the total calorie intake at a day admit to surgery

  From a preoperative clinic consultation (baseline) to a day admit to surgery, up to 3 months

• Change from Baseline in the total protein intake at a day admit to surgery

  From a preoperative clinic consultation (baseline) to a day admit to surgery, up to 3 months

Eligibility Criteria

• Age: 60 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The patients who enroll to Enchanced Recovery After Surgery (ERAS) program, Siriraj Hospital and referred to the SiPAP program

You may qualify if:

• Patients aged 60 years to 90 years
• Schedules for elective major surgery and formally enrollment in the Enhanced Recovery After Surgery (ERAS) program at Siriraj Hospital. (At Siriraj Hospital, patients scheduled for pre-specific elective major surgeries are enrolled into the ERAS program as individual hospital protocols for each ERAS module. All patients are informed about the ERAS program by their surgical team.)
• Referred to the SiPAP center for prehabilitation based on established ERAS hospital preoperative protocol.
• Able to provide written informed consent and willing to undergo all research assessments at both time points.

You may not qualify if:

• Presence of conditions that interfere with bioelectrical impedance analysis (BIA), including an implanted pacemaker or other non-removable electronic medical devices.
• Use of medications or supplements known to acutely or chronically affect muscle mass (e.g. corticosteroids, hormonal therapies) during the study period.
• Diagnosed neuromuscular disorders that affect baseline muscle mass and strength
• Undergo emergency surgery
• A planned interval of less than 14 days between the initial SiPAP visit and hospital admission for surgery.
• Alcohol consumption or strenuous exercise within the 12 hours preceding the scheduled BIA measurement.
• Incomplete data on muscle mass or nutritional assessment at either time point.

Sponsors & Collaborators

• Siriraj Hospital: lead

Study Sites (1)

Siriraj Integrated Preoperative And Prehabilitation Center : SiPAP

Bangkok Noi, Bangkok, 10700, Thailand

Location

Related Publications (7)

• Chaiwat O, Wongyingsinn M, Muangpaisan W, Chalermsri C, Siriussawakul A, Pramyothin P, Thitisakulchai P, Limpawattana P, Thanakiattiwibun C. A simpler screening tool for sarcopenia in surgical patients. PLoS One. 2021 Sep 23;16(9):e0257672. doi: 10.1371/journal.pone.0257672. eCollection 2021.

  PMID: 34555077 BACKGROUND

• Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSW, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020 Mar;21(3):300-307.e2. doi: 10.1016/j.jamda.2019.12.012. Epub 2020 Feb 4.

  PMID: 32033882 BACKGROUND

• Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) in Thai Setting and Association with Nutritional Parameters in Cancer Patients. Asian Pac J Cancer Prev. 2019 Apr 29;20(4):1249-1255. doi: 10.31557/APJCP.2019.20.4.1249.

  PMID: 31030501 BACKGROUND

• Taylor BE, McClave SA, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA, Gervasio JM, Sacks GS, Roberts PR, Compher C; Society of Critical Care Medicine; American Society of Parenteral and Enteral Nutrition. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med. 2016 Feb;44(2):390-438. doi: 10.1097/CCM.0000000000001525. No abstract available.

  PMID: 26771786 BACKGROUND

• Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017 Mar 1;152(3):292-298. doi: 10.1001/jamasurg.2016.4952.

  PMID: 28097305 BACKGROUND

• Li C, Carli F, Lee L, Charlebois P, Stein B, Liberman AS, Kaneva P, Augustin B, Wongyingsinn M, Gamsa A, Kim DJ, Vassiliou MC, Feldman LS. Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study. Surg Endosc. 2013 Apr;27(4):1072-82. doi: 10.1007/s00464-012-2560-5. Epub 2012 Oct 9.

  PMID: 23052535 BACKGROUND

• Arribas L, Sabate-Llobera A, Domingo MC, Taberna M, Sospedra M, Martin L, Gonzalez-Tampan AR, Pallares N, Mesia R, Baracos VE. Assessing dynamic change in muscle during treatment of patients with cancer: Precision testing standards. Clin Nutr. 2022 May;41(5):1059-1065. doi: 10.1016/j.clnu.2022.03.016. Epub 2022 Mar 11.

  PMID: 35395556 BACKGROUND

MeSH Terms

Conditions

Sarcopenia

Condition Hierarchy (Ancestors)

Muscular Atrophy; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Atrophy; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Signs and Symptoms

Study Officials

• Assoc. Prof. Mingkwan Wongyingsinn, MD

  Department Of Anesthesiology, Faculty Of Medicine Siriraj Hospital

  STUDY DIRECTOR

Central Study Contacts

Mingkwan Wongyingsinn, MD

CONTACT

0819153320; Mingkwan.won@mahidol.ac.th

Parujee Nakjuy, BSc

CONTACT

0822361415; Parujee.nak@mahidol.ac.th

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 3 Months
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: November 22, 2025
• First Posted: December 3, 2025
• Study Start: April 1, 2026
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 1, 2028
• Last Updated: March 6, 2026

Record last verified: 2025-12

Locations

TH (1)