title: Muscle strength as a predictor of loss of functional status in hospitalized patients.
abstract: OBJECTIVE
  The incidence of protein-calorie malnutrition in hospitalized adult patients can reach 30% to 50% and adversely affect clinical outcome. We evaluated the efficacy of muscle strength to predict functional derangement and detect early changes in nutrition status in hospitalized patients.
  
  
  METHODS
  Patients hospitalized at medical and surgical wards from two different hospitals in Santiago, Chile, were studied during their hospital stay. Subjective Global Assessment of nutrition status and laboratory parameters were measured on admission. Anthropometric measures, handgrip dynamometry, and maximal inspiratory and expiratory pressures were measured on admission and discharge. The Karnofsky index was used to assess functional status. Twice weekly, caloric balance was calculated with indirect calorimetry and assessment of dietary intake.
  
  
  RESULTS
  From the initial selection of patients (n = 70), 50 patients (26 men and 24 women) completed the study. Median hospital stay was 10 d. Subjective Global Assessment was associated with anthropometric data, handgrip dynamometry, and serum levels of total proteins. Patients in whom functional status declined during hospital stay, on admission had lower left handgrip strength, a worse Subjective Global Assessment classification, were older, and had lower fat mass. No association between caloric balance during hospital stay and changes in muscle strength was observed.
  
  
  CONCLUSIONS
  Subjective Global Assessment, handgrip strength, and fat mass were good predictors for the decline in functional status during hospital stay. No association between caloric balance and changes in muscle strength was observed.
authors.affiliation: Faculty of Medicine, Central Campus, University of Chile, Santiago, Chile.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Humphreys
authors.forename: Pia
authors.initials: P
authors.lastname: de la Maza
authors.forename: Sandra
authors.initials: S
authors.lastname: Hirsch
authors.forename: Gladys
authors.initials: G
authors.lastname: Barrera
authors.forename: Vivien
authors.initials: V
authors.lastname: Gattas
authors.forename: Daniel
authors.initials: D
authors.lastname: Bunout
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D005260:Female; D018737:Hand Strength; D006760:Hospitalization; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000175:diagnosis / Q000453:epidemiology; D012129:Respiratory Function Tests