title: Handgrip dynamometry: a surrogate marker of malnutrition to predict the prognosis in alcoholic liver disease.
abstract: BACKGROUND
  The aim of the study was to determine the utility of handgrip dynamometry (HGD) in predicting short term mortality and complications in alcoholic liver disease.
  
  
  METHODS
  Patients with alcoholic liver disease were included and nutritional assessment was done using the Subjective Global Assessment (SGA), HGD and other conventional parameters. Mortality rates and complications were compared to nutritional status.
  
  
  RESULTS
  80 patients were included in the study. Mean age of patients was 43.06±10.03 years. 69 patients survived and 11 patients died within the 3 month study duration. Handgrip strength (HGS) was higher in SGA A (28.76±5.48 kg) than SGA B (22.43±4.95 kg) and SGA C (16.78±3.83 kg) (P=<0.001). Number of complications including spontaneous bacterial Peritonitis, gastrointestinal bleeding and encephalopathy in SGA C group were 66.66%, in SGA B 20.75% and SGA A 10%. Mean HGS was significantly higher in the survivors (24.23±5.86) compared to non-survivors (18.04±4.82) (P=0.0011). There was a strong negative correlation between the HGS and Child-Pugh score (P=<0.0012). Multivariate logistic regression analysis to assess the risk factors for death showed handgrip to be in the suggestive significance range (P=0.072). The sensitivity of HGS was 88.41% in predicting short term mortality.
  
  
  CONCLUSIONS
  HGS correlates with Child-Pugh score in predicting short term mortality. HGD is a simple, inexpensive and sensitive tool for assessing the nutritional status in alcoholic liver disease and can reliably predict its complications and survival.
authors.affiliation: Department of Gastroenterology, Government Medical College and Super Specialty Hospital, Nagpur, Maharashtra, India.
authors.forename: Nitin Rangrao
authors.initials: NR
authors.lastname: Gaikwad
authors.affiliation: Department of Gastroenterology, Government Medical College and Super Specialty Hospital, Nagpur, Maharashtra, India.
authors.forename: Sudhir Jagdishprasad
authors.initials: SJ
authors.lastname: Gupta
authors.affiliation: Department of Gastroenterology, Government Medical College and Super Specialty Hospital, Nagpur, Maharashtra, India.
authors.forename: Amol Rajendra
authors.initials: AR
authors.lastname: Samarth
authors.affiliation: Department of Gastroenterology, Government Medical College and Super Specialty Hospital, Nagpur, Maharashtra, India.
authors.forename: Tushar Hiralal
authors.initials: TH
authors.lastname: Sankalecha
keywords: Handgrip dynamometry; mortality; nutritional status