Hand grip strength as predictor of undernutrition in hospitalized patients with cancer and a proposal of cut-off

Mendes, Nélia Pinheiro; Barros, Thalita Alves de; Faria, Bruna Soares; Aguiar, Erica Silva; Oliveira, Cristiane Alves de; Souza, Eliana Carla Gomes de; Pereira, Sandra de Oliveira; Rosa, Carla de Oliveira Barbosa

doi:10.1016/j.clnesp.2020.06.011

Cited by 22 publications

(15 citation statements)

References 14 publications

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“… 4 A previous study showed that HGS could be used as a predictor of malnutrition in individuals with cancer. 6 In addition, several studies 7 , 8 , 9 also showed that low HGS was inversely related to the survival outcomes of cancer, but was different in male and female patients. Otherwise, a recent study also reported that low HGS was strongly associated with cancer mortalities based on a multicentre observational study.…”

Section: Introductionmentioning

confidence: 99%

“…Hand grip strength (HGS) is considered a reliable instrument to predict the total skeletal muscle mass, 5 being an easy and non‐invasive method, and was recommended to be a criterion in the definition of cancer cachexia 4 . A previous study showed that HGS could be used as a predictor of malnutrition in individuals with cancer 6 . In addition, several studies 7–9 also showed that low HGS was inversely related to the survival outcomes of cancer, but was different in male and female patients.…”

Section: Introductionmentioning

confidence: 99%

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Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study

Song

Zhang

Tang

et al. 2021

J cachexia sarcopenia muscle

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Backgrounds Hand grip strength (HGS) is one of diagnose criteria factors of sarcopenia and is associated with the survival of patients with cancer. However, few studies have addressed the association of HGS and 1 year mortality of patients with cancer cachexia. Methods This cohort study included 8466 patients with malignant solid tumour from 40 clinical centres throughout China. Cachexia was diagnosed using the 2011 International cancer cachexia consensus. The hazard ratio (HR) of all cancer cachexia mortality was calculated using Cox proportional hazard regression models. Kaplan–Meier curves were generated to evaluate the association between HGS and the 1 year mortality of patients with cancer cachexia. The interaction analysis was used to explore the combined effect of low HGS and other factors on the overall survival of patients with cancer cachexia. Results Among all participants, 1434 (16.9%) patients with cancer were diagnosed with cachexia according to the 2011 International cancer cachexia consensus with a mean (SD) age of 57.75 (12.97) years, among which there were 871 (60.7%) male patients. The HGS optimal cut‐off points of male and female patients were 19.87 and 14.3 kg, respectively. Patients with cancer cachexia had lower HGS than those patients without cachexia (P < 0.05). In the multivariable Cox analysis, low HGS was an independent risk factor of cachexia [HR: 1.491, 95% confidence interval (CI): 1.257–1.769] after adjusting other factors. In addition, all of cancer cachexia patients with lower HGS had unfavourable 1 year survival (P < 0.001). In a subset analysis, low HGS was an independent prognosis factor of male patients with cancer cachexia (HR: 1.623, 95% CI: 1.308–2.014, P < 0.001), but not in female patients (HR: 1.947, 95% CI: 0.956–3.963, P = 0.0662), and low HGS was associated with poor 1 year survival of digestive system, respiratory system, and other cancer cachexia patients (all P < 0.05). Low HGS has combined effects with high neutrophil‐to‐lymphocyte ratio or low albumin on unfavourable overall survival of patients with cancer cachexia. Conclusions Low HGS was associated with poor 1 year survival of patients with cancer cachexia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study

Song

Zhang

Tang

et al. 2021

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

show abstract

“…A Brazilian study with patients with different types of cancer at different stages proposed HGS <32.5 kg as the cutoff for both sexes for predicting malnutrition and identifying lower HGS. 49 The cutoff points for MUAMA proposed in the international consensus on cancer cachexia for low muscle mass are <32 cm² for men and <18 cm² for women based in Canadian health adults. 11 The cutoff points found in the present study were almost always lower than those reported in the aforementioned studies.…”

Section: Discussionmentioning

confidence: 99%

“…In a study of Chinese patients with mostly advanced‐stage cancer, Zhuang et al 48 found HGS < 22.0 kg for men and <16.1 kg for women as the cutoff points were associated with mortality. A Brazilian study with patients with different types of cancer at different stages proposed HGS <32.5 kg as the cutoff for both sexes for predicting malnutrition and identifying lower HGS 49 . The cutoff points for MUAMA proposed in the international consensus on cancer cachexia for low muscle mass are <32 cm² for men and <18 cm² for women based in Canadian health adults 11 .…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a grading system for assessing muscle mass phenotype using mid‐upper arm muscle area and handgrip strength in patients with incurable cancer

et al. 2022

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Background: This study aimed to develop and validate a distinct method to evaluate muscle mass phenotype in patients with incurable cancer based on a combination of mid-upper arm muscle area (MUAMA) and handgrip strength (HGS).Methods: This prospective cohort study was conducted with patients with incurable cancer who were enrolled at the palliative care unit of a cancer institute. The 1,660 patients were randomized into two data sets: training (70%; n = 1162), used to determine the muscle mass phenotype groups, derived from a combination of MUAMA and HGS cutoff points related to 180-days mortality; and validation (30%; n = 498), used to evaluate the relationship of the proposed muscle phenotype grading system with performance status, body composition, nutrition status, and mortality. Results:The training data set resulted in three distinct groups formed by combining the cutoff points of MUAMA and HGS, with the best muscle mass phenotype being group 1, the group with any impairment of muscle mass being the 2, and the worst muscle mass phenotype being group 3. In the validation data set, lower performance status (both sexes p < 0.001), worse skeletal muscle index (both sexes p < 0.001), muscle radiodensity (men, p = 0.001; women, p = 0.008), and nutritional status (men, p = 0.003; women, p < 0.001) were observed as MUAMA and HGS values diminished. Patients in group 3 presented significantly higher risk of 180-day mortality (both sexes p < 0.001). Conclusion:The muscle mass phenotype grading system proved to be able to identify patients with lower performance status, worse body composition measurements and nutritional status, and higher risk of death in 180 days.

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“…It measures the isometric muscle strength of the hand and forearm, and maximum strength is calculated by the mean of three trials [90]. It is found to be valid and relevant in assessing nutritional status [91].…”

Section: Secondary Outcomesmentioning

confidence: 99%

Mobile Health Technology, Exercise Adherence and Optimal Nutrition post rehabilitation among people with Parkinson’s Disease (mHEXANUT) – a Randomized controlled trial protocol

Alnes

Lærum-Onsager

Bye

et al. 2022

Preprint

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Background Although it is well known that regular physical activity and exercise, as well as maintaining adequate nutritional status is important to delaying symptom development and maintaining physical capacity and function in people with Parkinson’s Disease (PD), many are unable to follow self-management recommendations. Active interventions have shown short-term effects, but there is a need for interventions that facilitate self-management over the course of the disease. Until now, no studies have combined exercise and nutritional interventions with an individual self-management approach in PD. Thus, we aim to examine the effect of a six-month mobile health technology(m-health)-based follow-up programme, focusing on self-management in exercise and nutrition, after an in-service interdisciplinary rehabilitation programme. Methods A single-blinded, two-group randomised controlled trial. Participants are Adults aged 40 or older, with idiopathic PD, Hoehn-Yahr 1-3, living at home. The intervention group receives a monthly, individualized, digital conversation with a PT, combined with use of an activity tracker. People at nutritional risk get additional digital-follow-up from a nutritional specialist. The control group receives usual care. The primary outcome is physical capacity, measured by 6-minute walk test (6MWT). Secondary outcomes are nutritional status, Health related quality of life (HRQOL), physical function and exercise adherence. All measurements are performed at baseline, after 3 months and after 6 months. Sample size, based on primary outcome, is set at 100 participants randomized into the two arms, including an estimated 20% drop out. Discussion The increasing prevalence of PD globally makes it even more important to develop evidence-based interventions that can increase motivation to stay active, promote adequate nutritional status and improve self-management in people with PD. Theindividually tailored digital follow-up programme, based on evidence-based practice, has the potential to promote evidence-based decision-making and to empower people with PD to implement exercise and optimal nutrition in their daily lives and, hopefully, increase adherence to exercise and nutritional recommendations. Trial Registration ClinicalTrials.gov (NCT04945876). First registration 01.03.2021.

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Hand grip strength as predictor of undernutrition in hospitalized patients with cancer and a proposal of cut-off

Cited by 22 publications

References 14 publications

Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study

Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study

Development and validation of a grading system for assessing muscle mass phenotype using mid‐upper arm muscle area and handgrip strength in patients with incurable cancer

Mobile Health Technology, Exercise Adherence and Optimal Nutrition post rehabilitation among people with Parkinson’s Disease (mHEXANUT) – a Randomized controlled trial protocol

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