Admission Handgrip Strength Predicts Functional Decline in Hospitalized Patients

Clinical Nutrition ESPEN. 2017 Feb; 17:28-32. doi: 10.1016/j.clnesp.2016.12.001. Epub 2016 Dec 22.
Olguín, T., Bunout, D., de la Maza, M. P., Barrera, G., & Hirsch, S.


Problem: Up to 35% of hospitalized patients may experience functional decline during or after hospitalization. Subjective Global Assessment (SGA) and handgrip strength at admission, have been proposed as simple and accessible tools to predict functional decline, but there are few studies in hospitalized patients to confirm these findings.

Objective: To assess the predictive value of handgrip strength at hospital admission, on functional decline after 30 days.

Methods: 125 non-critical patients hospitalized for medical and surgical conditions, were studied in El Pino hospital in Santiago, Chile. Upon admission, nutritional status was assessed by SGA, functional status through the Karnofsky index (KI), and handgrip strength by dynamometry. Change in functionality was assessed by the difference between KI at admission and 30 days later. Multivariate logistic regression models were used to establish associations between the variables at hospital admission, and subsequent functional decline.

Results: Thirty days post-hospital admission, 28.8% of the sample showed functional decline. In a multivariate analysis, only handgrip strength was associated with this decline (β = -0.025, OR = 0.974 (CI 0.956-0.992), p = 0.007).

Conclusions: Handgrip strength upon hospital admission can be a useful independent and early method to predict deterioration of functional status during hospitalization.

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List of abbreviations

DGEM German Society for Nutritional Medicine (German Deutsche Gesellschaft für Ernährungsmedizin)
GESKES  Swiss Society for Clinical Nutrition (German Gesellschaft für klinische Ernährung der Schweiz) 
ESPEN European Society of Clinicl Nutrition and Metabolism