title: Handgrip strength measurement as a predictor of hospitalization costs.
abstract: BACKGROUND
  Undernutrition status at hospital admission is related to increased hospital costs. Handgrip strength (HGS) is an indicator of undernutrition, but the ability of HGS to predict hospitalization costs has yet to be studied.
  
  
  OBJECTIVE
  To explore whether HGS measurement at hospital admission can predict patient's hospitalization costs.
  
  
  METHODS
  A prospective study was conducted in a university hospital. Inpatient's (n=637) HGS and undernutrition status by Patient-Generated Subjective Global Assessment were ascertained. Multivariable linear regression analysis, computing HGS quartiles by sex (reference: fourth quartile, highest), was conducted in order to identify the independent predictors of hospitalization costs. Costs were evaluated through percentage deviation from the mean cost, after adjustment for patients' characteristics, disease severity and undernutrition status.
  
  
  RESULTS
  Being in the first or second HGS quartiles at hospital admission increased patient's hospitalization costs, respectively, by 17.5% (95% confidence interval: 2.7-32.3) and 21.4% (7.5-35.3), which translated into an increase from €375 (58-692) to €458 (161-756). After the additional adjustment for undernutrition status, being in the first or second HGS quartiles had, respectively, an economic impact of 16.6% (1.9-31.2) and 20.0% (6.2-33.8), corresponding to an increase in hospitalization expenditure from €356 (41-668) to €428 (133-724).
  
  
  CONCLUSIONS
  Low HGS at hospital admission is associated with increased hospitalization costs of between 16.6 and 20.0% after controlling for possible confounders, including undernutrition status. HGS is an inexpensive, noninvasive and easy-to-use method that has clinical potential to predict hospitalization costs.
authors.affiliation: 1] Departamento de Bioquímica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal [2] UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal [3] Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: R S
authors.initials: RS
authors.lastname: Guerra
authors.affiliation: 1] UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal [2] Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal.
authors.forename: T F
authors.initials: TF
authors.lastname: Amaral
authors.affiliation: 1] Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal [2] Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal.
authors.forename: A S
authors.initials: AS
authors.lastname: Sousa
authors.affiliation: Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: F
authors.initials: F
authors.lastname: Pichel
authors.affiliation: UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal.
authors.forename: M T
authors.initials: MT
authors.lastname: Restivo
authors.affiliation: Serviço de Informação de Gestão, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Ferreira
authors.affiliation: Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: I
authors.initials: I
authors.lastname: Fonseca
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018737:Hand Strength; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007297:Inpatients; D016014:Linear Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000191:economics; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011446:Prospective Studies; D055815:Young Adult