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Reduced Handgrip Strength in Hospital Admission Predicts Prolonged Hospital Stay and Death but Is Not Accurate to Identify Malnutrition: A Longitudinal Study of Reduced Handgrip Strength in Hospitalized Patients
Author(s) -
Chites Victória Silva,
Teixeira Paula Portal,
Lima Julia,
Burgel Camila Ferri,
Gattermann Pereira Thainá,
Silva Flávia Moraes
Publication year - 2021
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1976
Subject(s) - medicine , malnutrition , hand strength , prospective cohort study , concordance , receiver operating characteristic , odds ratio , cohort study , body mass index , pediatrics , grip strength , physical therapy
Background Malnourished patients present impairment of functionality due to loss of strength and muscle mass. However, the validity of handgrip strength (HGS) in identifying malnutrition and its association with clinical outcomes in hospitalized patients requires investigation. Aims Evaluate the accuracy of HGS in identifying malnutrition, its association with clinical outcomes, and the change in HGS in the first 2 weeks of hospitalization. Methods A prospective cohort study with adult/elderly patients. Subjective Global Assessment (SGA) was applied in the first 48 hours for malnutrition diagnosis, and HGS was measured in this moment and after 7 and 14 days of hospital admission. HGS <20 kg for females and <30 kg for males was considered reduced. Outcomes of interest were prolonged hospital stay (LOS) and in‐hospital death. Results Six hundred patients (55.75 ± 14.78 years, 51.5% males) were included, 34.0% of them were malnourished (SGA‐B or SGA‐C), and 37.2% presented reduced HGS. The concordance between reduced HGS and SGA in malnutrition diagnosis was weak (κ = 0.192), and accuracy was not satisfactory (area under the receiver operating characteristic curve = 0.599 [95% CI, 0.551–0.648]). HGS did not change during the hospitalization. Reduced HGS increased by 1.2 times (95% CI, 1.03–1.40) the odds for prolonged LOS and 9.11 times (95% CI, 1.13–73.60) the risk of death. Conclusion Reduced HGS did not present satisfactory accuracy to identify malnutrition, and HGS did not change during the first 14 days of hospitalization, but was associated with prolonged LOS and in‐hospital death.