Open AccessProspective assessment of combined handgrip strength and Mini‐Cog identifies hospitalized heart failure patients at increased post‐hospitalization risk
Author(s) -
Joyce Emer,
Howell Erik H.,
Senapati Alpana,
Starling Randall C.,
Gorodeski Eiran Z.
Publication year - 2018
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12300
Subject(s) - medicine , grip strength , heart failure , prospective cohort study , cog , physical therapy , hand strength , cohort , cognitive impairment , cohort study , disease , artificial intelligence , computer science
Aims The utility of combined assessment of both frailty and cognitive impairment in hospitalized heart failure (HF) patients for incremental post‐discharge risk stratification, using handgrip strength and Mini‐Cog as feasible representative parameters, was investigated. Methods and results A prospective, single‐centre cohort study of older adults (age ≥65) hospitalized for HF being discharged to home was performed. Pre‐discharge, grip strength was assessed using a dynamometer (Jamar hydrolic hand dynamometer, Lafayette Instruments, Lafayette, IN, USA) and was defined as weak if the maximal value was below the gender‐derived and body mass index‐derived cut‐offs according to Fried criteria. Cognition was assessed using the Mini‐Cog. The presence of impairment was defined as a score of <2. Outcome measures were all‐cause readmission or emergency department visit (primary) or all‐cause mortality (secondary) at 6 months. A total of 56 patients (mean age 77 ± 7 years, 73% male) were enrolled. The majority ( n = 33, 59%) had weak grip strength, either with ( n = 5) or without ( n = 28) cognitive impairment. The highest risk for both readmission and mortality occurred in those with weak grip strength and cognitive impairment in combination (log‐rank P < 0.0001 and P = 0.01, respectively). Conclusions Patients who are frail by grip strength assessment and cognitively impaired according to severely reduced Mini‐Cog performance show the worst midterm post‐discharge outcomes after HF hospitalization.