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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, Reduced handgrip strength in hospitalized patients.

BACKGROUND
Malnourished patients present impairment of functionality due to loss of strength associated with loss of muscle mass. However, the validity of handgrip strength (HGS) in identifying malnutrition and its association with clinical outcomes in hospitalized patients requires investigation.


AIMS
To evaluate the accuracy of HGS in identifying malnutrition, its association with clinical outcomes, and the change in HGS in the first two weeks of hospitalization.


METHODS
Prospective cohort study with adult/elderly patients. Subjective global assessment (SGA) was applied in the first 48h for malnutrition diagnosis and HGS was measured in this moment and after seven and 14 days of hospital admission. HGS< 20 kg for females and < 30 kg for males were considered reduced. Outcomes of interest were prolonged hospital stay and in-hospital death.


RESULTS
600 patients (55.75±14.78 years, 51.5% males) were included, 34.0% of them were malnourished (SGA B or C) and 37.2% presented reduced HGS. The concordance between reduced HGS and SGA in malnutrition diagnosis was weak (kappa = 0.192) and accuracy was not satisfactory [AUC ROC curve = 0.599 (CI95% 0.551 - 0.648)]. HGS did not change during the hospitalization. Reduced HGS increased in 1.2 times (CI95% 1.03 - 1.40) the odds for prolonged hospital stay and in 9.11 times (CI95% 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 hospital stay, however was associated with prolonged hospital stay and in-hospital death. This article is protected by copyright. All rights reserved.