Relationship Between Handgrip Strength and Length of Stay for Left Ventricular Assist Device Implantation.
BACKGROUND
Advanced heart failure is associated with a wide range of physiological derangements, including muscular deterioration, weight loss, and cardiac cachexia. These conditions, as well as poor nutrition status, have been shown to affect the quality of outcomes in patients who undergo left ventricular assist device (LVAD) implantation. Noting that handgrip strength has been shown to be an effective indicator of poor functional status, muscular strength, and nutrition, we investigated its use as a tool for prediction of length of stay (LOS) in patients undergoing LVAD implantation.


METHODS
Handgrip strength was measured in 90 patients undergoing evaluation for LVAD implantation using the Jamar Hand Dynamometer. Handgrip strength was normalized to body weight (HGS:BW), and patients were divided into 2 groups: those with HGS:BW <28.5% and those with HGS:BW ≥28.5%. Clinical data and length of stay were compared between groups.


RESULTS
Patients with lower HGS:BW tended to have worsened clinical indicators of heart failure severity, including reduced ejection fraction, serum albumin, and hemoglobin and increased B-type natriuretic peptide and white blood cell count. Lower HGS:BW was an independent predictor for increased LOS.


CONCLUSIONS
Handgrip strength measurement at the bedside is a simple and effective means of assessing functional status and risk for increased LOS following LVAD implantation, which may aid in preoperative evaluation of LVAD candidacy.
1 Advocate Christ Medical Center, Center for Heart Transplant and Assist Devices, Oak Lawn, Illinois, USA.
Gardner
G
Yost
1 Advocate Christ Medical Center, Center for Heart Transplant and Assist Devices, Oak Lawn, Illinois, USA.
Geetha
G
Bhat
D000328:Adult; D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D015331:Cohort Studies; D005260:Female; D018737:Hand Strength; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D015596:Nutrition Assessment; D009752:Nutritional Status; D000067716:Point-of-Care Testing; D012720:Severity of Illness Index; D013318:Stroke Volume
D015415:Biomarkers
hand strength; heart failure; heart-assist devices; left ventricular assist device; length of stay; nutritional status