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Southampton Arm Fracture Frailty and Sarcopenia Study (SAFFSS): a study protocol for the feasibility of assessing frailty and sarcopenia among older patients with an upper limb fracture
  1. Kinda Ibrahim1,2,3,
  2. Mark Mullee3,
  3. Guiqing Lily Yao4,
  4. Shihua Zhu3,
  5. Mark Baxter5,6,
  6. Simon Tilly5,
  7. Cynthia Russell2,
  8. Helen C Roberts1,2,3,5
  1. 1 Academic Geriatric Medicine, Faculty of Medicine, Southampton University, Southampton, UK
  2. 2 NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
  3. 3 Faculty of Medicine, University of Southampton, Southampton, UK
  4. 4 Department of Health Sciences, University of Leicester, Leicester, UK
  5. 5 Trauma and Orthopaedic Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  6. 6 Medicine for Older People, University Hospital Southampton, Southampton, UK
  1. Correspondence to Dr Kinda Ibrahim; k.ibrahim{at}


Introduction Falls are a major health problem for older people; 35% of people aged 65+ years fall every year, leading to fractures in 10%–15%. Upper limb fractures are often the first sign of osteoporosis and routine screening for osteoporosis is recommended by the National Institute for Health and Care Excellence to prevent subsequent hip fractures. However, both frailty and sarcopenia (muscle weakness) are associated with increased risk of falling and fracture but are not routinely identified in this group. The aim of this study is to evaluate the feasibility of assessing and managing frailty and sarcopenia among people aged 65+ years with an upper limb fracture.

Methods and analysis This study will be conducted in three fracture clinics in one acute trust in England. 100 people aged 65+ years with an upper arm fracture will be recruited and assessed using six validated frailty measures and two sarcopenia tools. The prevalence of the two conditions and the best tools to use will be determined. Those with either condition will be referred to geriatric clinical teams for comprehensive geriatric assessment (CGA). We will document the proportion who are referred for CGA and those who receive CGA. Other outcome measures including falls, fractures and healthcare resource use over 6 months will be collected. In-depth interviews with a purposive sample of patients who undergo the frailty and sarcopenia assessments and healthcare professionals in fracture clinics and geriatric services will be carried out to their acceptability of assessing frailty and sarcopenia in a busy environment.

Ethics and dissemination The study was given the relevant ethical approvals from NHS Research Ethics Committee (REC No: 18/NE/0377), the University Hospital Southampton NHS Foundation Trust, and the University of Southampton, Faculty of Medicine Ethics Committee and Research Governance Office. Findings will be published in scientific journals and presented to local, national and international conferences.

Trial registration number ISRCTN13848445

  • frailty
  • sarcopenia
  • fracture
  • older people
  • feasibility

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  • Contributors KI, MM, LY, SZ, MB, ST, CR and HCR contributed to the conception and design of the study. KI and HR drafted the manuscript. KI is managing day-to day research activities, recruitment, data collection, and data entry. MM, SZ and LY completed the quantitative and health economic analysis sections in this manuscript and developed the analysis plan. MB, ST and CR developed the recruitment strategy for this study and CR reviewed all patient-facing documents. KI, MM, LY, SZ, MB, ST, CR and HCR read and approved the final manuscript.

  • Funding This work is supported by the National Institute of Health Research (NIHR) Research for Patient Benefit (RfPB) program grant number [PB-PG-0317-20043]’. The study is sponsored by the University Hospital Southampton NHS Foundation Trust (Protocol ID: RHM MED 1580).

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. HCR and KI received support from the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex and the University of Southampton. HCR received support from the NIHR Southampton Biomedical Research Centre.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was given by the North East-Newcastle and North Tyneside 1 NRES Committee (REC No: 18/NE/0377) and has been reviewed by the Research and Development team at University Hospital Southampton NHS Foundation Trust

  • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.

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