Potential Prognostic Value of Handgrip Strength in Older Hospitalized Patients.
OBJECTIVE
Objective measures of physical function are useful prognostic tools also for hospitalized elders. Low handgrip strength is predictive of poor outcomes and it can be assessed also in a sitting position, representing a potential alternative measure in bedridden patients. We evaluated grip strength prognostic value in hospitalized older patients.


METHODS
Prospective cohort study.


METHODS
Geriatric, medical ward of an academic medical center in Ferrara, Italy.


METHODS
Patients aged 65 and older (N = 88) admitted to the hospital for an acute medical condition.


METHODS
Patients were evaluated for grip strength at hospital admission and were re-evaluated at discharge. After discharge, they were followed every 3 months for 1 year by telephone interviews to assess new hospitalizations and vital status.


RESULTS
The mean age of the sample was 77.3 years, 47% were women. At admission, mean height standardized handgrip strength was 15.7±5 kg/m; men had greater strength (p<0.001). There was a direct relationship of admission grip strength with BMI (p<0.05), serum albumin (p=0.07), and Short Physical Performance Battery score (p<0.05), and an inverse relationship with age (gender-adjusted p value <0.01). In multiple regression analysis, after adjustment for possible confounders, patients in third tertile of grip strength had a shorter hospital stay compared to those in the first tertile (β -2.8; p<0.05). Patients with higher grip strength at discharge also had a lower risk of rehospitalization or death over the follow-up, although the result was not statistically significant (OR: 0.68; 95% CI: 0.30-1.52).


CONCLUSIONS
In older hospitalized medical patients, grip strength assessment might provide useful prognostic information.
Stefano Volpato, MD, MPH, Department of Clinical and Experimental Medicine, University of Ferrara, Via Savonarola, 9, I-44100 Ferrara, ITALY, e-mail vlt@unife.it, phone +39-0532-247409, FAX +39-0532-210884.
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