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Prediction of risk of falls based on handgrip strength in chronic liver disease patients living independently
Author(s) -
Hiraoka Atsushi,
Tamura Rumi,
Oka Misato,
Izumoto Hirofumi,
Ueki Hidetaro,
Tsuruta Miho,
Yoshino Takeaki,
Ono Atsushi,
Aibiki Toshihiko,
Okudaira Tomonari,
Yamago Hiroka,
Suga Yoshifumi,
Iwasaki Ryuichiro,
Mori Kenichiro,
Miyata Hideki,
Tsubouchi Eiji,
Kishida Masato,
Ninomiya Tomoyuki,
Hirooka Masashi,
Abe Masanori,
Matsuura Bunzo,
Hiasa Yoichi,
Kino Tsutae,
Yamamoto Kayo,
Michitaka Kojiro
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13322
Subject(s) - medicine , cirrhosis , chronic liver disease , confidence interval , liver function , receiver operating characteristic , fear of falling , falling (accident) , pediatrics , physical therapy , poison control , injury prevention , emergency medicine , environmental health
Aim Falling is known to be associated with cognitive function. We evaluated the relationship between muscle function and falls in patients with chronic liver disease (CLD). Methods We enrolled 100 sequential CLD patients without dementia who were admitted to our institution for scheduled treatment from July 2017 to May 2018 (age 71.0 ± 10.2 years; 76 men). All subjects were self‐reliant in regard to activities of daily living. On admission, handgrip strength was determined and falls within 1 month of admission were noted. For determining handgrip strength decline (HSD), previously reported values were used (men, <26 kg; women, <18 kg). The relationship between HSD and falls in CLD patients was evaluated in a retrospective manner. Results Thirty‐two patients had chronic hepatitis and 49 had liver cirrhosis (LC) Child–Pugh A, 17 had LC Child–Pugh B, and 2 had LC Child–Pugh C. Twelve (12.0%) had a history of falling, including 8 (26.7%) of 30 with and 4 (5.7%) of 70 without HSD ( P = 0.006). The cut‐off value for age in relationship to falling was 69.0 years old (area under the receiver operating characteristic curve, 0.668; 95% confidence interval, 0.514–0.821). A fall during hospitalization was noted more often in patients with a history of falling than in those without (16.7% [2/12] vs. 2.3% [2/88], P = 0.018). Conclusion In CLD patients, the presence of HSD and older age might be independent risk factors for predicting a fall. Assessment of handgrip strength could be an effective clinical tool for easily assessing the risk of falling, especially in elderly CLD patients.