Handgrip strength predicts 1-year functional recovery and mortality in hip fracture patients

Pérez-Rodríguez, Patricia; Rabes-Rodríguez, Laura; Sáez-Nieto, Carmen; Alarcón, T.; Queipo, Rocío; Otero-Puime, Ángel; González-Montalvo, Juan Ignacio

doi:10.1016/j.maturitas.2020.06.013

Cited by 13 publications

(18 citation statements)

References 29 publications

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“…In concurrence with studies that have reported predictors of mortality risk following hip surgery, 17,34,36,37 our study also demonstrated that male sex, high preoperative serum creatinine, low baseline handgrip strength, and high CCI were poor indictors of a high risk of mortality within 1 year of hip surgery in the geriatric population. In addition, long surgical delay after a falling accident was an important predictor for mortality risk in this study.…”

Section: Discussionsupporting

confidence: 91%

Prognostic factors for 1-year functional outcome, quality of life, care demands, and mortality after surgery in Taiwanese geriatric patients with a hip fracture: a prospective cohort study

Chen

Kuo

Liu

et al. 2021

Therapeutic Advances in Musculoskeletal

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Background: Hip fractures are a major public health concern among elderly individuals. This study aimed to investigate potential perioperative factors that predict 1-year functional outcome, quality of life (QoL), care demands, and mortality in geriatric patients with a hip fracture. Methods: We prospectively enrolled geriatric patients who had undergone hip fracture surgery in one medical center from December 2017 to December 2019. Basic demographic data, handgrip strength, and responses to questionnaires for QoL and activities of daily living (ADL) before the injury were collected at baseline. QoL, ADL, additional care demands other than family support, and mortality events were monitored at 1 year after the operation. Results: Among 281 patients with a hip fracture, 39 (13.9%) died within 1 year of the index operation. The mean follow-up interval for the survivors was 403.3 (range: 358–480) days. Among the 242 survivors, ADL and QoL considerably decreased at approximately 1 year following hip surgery. Up to 33.9% of the participants became severely dependent and needed additional care at 1-year follow up. Prefracture ADL status was the crucial predictor for functional outcome, QoL, and additional care demand at 1-year follow up. Cox regression models indicated that male sex, low preoperative serum creatinine, handgrip strength, long surgical delay after a falling accident, and high Charlson Comorbidity Index were considerably associated with a high 1-year mortality risk in the geriatric hip fracture population. Conclusion: Hip fracture has long-lasting effects (e.g. functional loss, decline in QoL, increased care demands, and high postoperative mortality rate) on the geriatric population. A robust screening method must be developed for identifying potential prognostic factors, and a stratified care approach must be used that accounts for personalized risks to improve functional outcomes and reduce mortality after hip fracture in geriatric patients, especially in Taiwan.

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Section: Discussionsupporting

confidence: 91%

Prognostic factors for 1-year functional outcome, quality of life, care demands, and mortality after surgery in Taiwanese geriatric patients with a hip fracture: a prospective cohort study

Chen

Kuo

Liu

et al. 2021

Therapeutic Advances in Musculoskeletal

View full text Add to dashboard Cite

show abstract

“…Second, we did not collect the parameter that represents muscle mass; thus, we cannot calculate sarcopenia and investigate the association between sarcopenia and 90-day mortality. Third, the follow-up length of our study was relatively short-term, which prevents us from comparing our findings to other studies that included long-term outcomes ( 10 , 11 ). Fourth, although our study was a prospective cohort study, we cannot draw a definite conclusion on causal inference.…”

Section: Discussionmentioning

confidence: 91%

“…Recently, numerous studies have reported that patients with low handgrip strength are at increased risk of mortality or cardiovascular disease (CVD) mortality in different settings, such as in the community and hospital, in various countries (9)(10)(11). However, few studies have been conducted in a Chinese population.…”

Section: Introductionmentioning

confidence: 99%

Association Between Low Handgrip Strength and 90-Day Mortality Among Older Chinese Inpatients: A National Multicenter Prospective Cohort Study

et al. 2021

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Background: The knowledge of the association between low handgrip strength and mortality among older Chinese inpatients is limited. Given China's aging society, a great number of older adults require hospital admission.Objective: To explore the association between low handgrip strength and 90-day mortality, providing evidence for clinicians to predict the risk of mortality and improve clinical outcomes for older inpatients.Materials and Methods: We conducted a national multicenter cohort study with a baseline survey from October 2018 to February 2019 and followed up for 90 days to record mortality outcomes. The assessment of handgrip strength was conducted using a hand dynamometer with the cutoff (handgrip strength < 28 kg for men and < 18 kg for women) to define low handgrip strength. Multivariable logistic regression analysis was applied to explore the association between low handgrip strength and 90-day mortality.Results: A total of 8,910 older Chinese inpatients [mean (SD) age, 72.39 (5.68) years; 3,750 women (42.09%)], with a prevalence of low handgrip strength, at 49.57%, were included. Compared to inpatients with normal handgrip strength, inpatients with low handgrip strength were older, had less education, more were female, had lower activities of daily living (ADL) score, had lower BMI, higher frailty, higher rates of depression, and poorer cognitive function (all p < 0.05). At 90 days, after adjusting for gender, age, education, frailty, depression, ADL score, malnutrition, and diagnosis, low handgrip strength was independently associated with 90-day mortality, compared to normal handgrip strength (OR = 1.64, 95% CI:1.14–2.37; P = 0.008). Additionally, subgroup and interaction analysis showed a significant interaction effect (P = 0.031) between two age groups (65–74 years older vs. ≥ 75 years old), with the OR being 3.19 (95%CI:2.07–4.93) and 1.49 (95%CI:0.87–2.55), respectively.Conclusion: Older Chinese inpatients with low handgrip strength had a 1.64-fold risk of 90-day mortality, compared to those with normal handgrip strength, indicating that clinicians need to screen early for handgrip strength and recommend corresponding interventions, such as resistance training and nutrition, as a priority for older inpatients.Clinical Trial Registration: Chinese Clinical Trial Registry, Identifier: ChiCTR1800017682.

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“…It is associated with bone mineral density [ 37 ] and dynamic body balancing ability [ 43 ]; thus, a low hand grip strength is a risk factor for falls and fractures [ 8 ]. Hand grip strength can also be a predictor of surgical outcomes [ 9 , 10 ]. Based on the clinical significance of grip strength and the effect of genetic variations in APOE on grip strength, we suspect that APOE rs405509 polymorphisms might serve as one of the genetic markers for predicting diseases and the risk of fracture associated with lower grip strength.…”

Section: Discussionmentioning

confidence: 99%

“…In the field of surgery, a decline in hand grip strength is associated with an increased risk of fracture at the distal forearm, vertebrae, hip, and so on [ 7 , 8 ]. Hand grip strength may also be used as a predictor to evaluate the outcomes of orthopaedic surgery and fracture surgery [ 9 , 10 ]. Therefore, hand grip strength is an effective indicator of the general health condition and has clinical significance.…”

Section: Introductionmentioning

confidence: 99%

Effects of the association between APOE rs405509 polymorphisms and gene-environment interactions on hand grip strength among middle-aged and elderly people in a rural population in southern China

Liu

et al. 2021

J Orthop Surg Res

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Background Hand grip strength is a complex phenotype. The current study aimed to identify the effects of the association between APOE rs405509 polymorphisms and gene-environment interactions on hand grip strength among middle-aged and elderly people in a rural population in Gongcheng, southern China. Methods APOE rs405509 polymorphisms in 1724 participants (695 men and 1029 women, aged 45–97 years old) were genotyped using the Sequenom MassARRAY platform. Statistical analysis was conducted using SPSS 21.0 and Plink 1.90. Results The APOE rs405509 G allele was associated with lower hand grip strength in all participants (β = −1.04, P value <0.001), and the correlation seemed to be even stronger among women. A significant gene-environment interaction was observed between APOE rs405509 and smoking, especially in men. The hand grip strength of male smokers carrying the GG genotype was significantly higher than that of nonsmokers (P value = 0.004). Conclusions APOE rs405509 polymorphisms might be genetic factors that affect hand grip strength in a rural population in Gongcheng, southern China. The APOE rs405509-smoking interaction has an impact on hand grip strength.

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Handgrip strength predicts 1-year functional recovery and mortality in hip fracture patients

Cited by 13 publications

References 29 publications

Prognostic factors for 1-year functional outcome, quality of life, care demands, and mortality after surgery in Taiwanese geriatric patients with a hip fracture: a prospective cohort study

Prognostic factors for 1-year functional outcome, quality of life, care demands, and mortality after surgery in Taiwanese geriatric patients with a hip fracture: a prospective cohort study

Association Between Low Handgrip Strength and 90-Day Mortality Among Older Chinese Inpatients: A National Multicenter Prospective Cohort Study

Effects of the association between APOE rs405509 polymorphisms and gene-environment interactions on hand grip strength among middle-aged and elderly people in a rural population in southern China

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