Outpatient grip strength measurement predicts survival, perioperative adverse events, and nonhome discharge among patients with vascular disease

Reeve, Thomas E.; Craven, Timothy E.; Goldman, Matthew P.; Hurie, Justin B.; Velazquez-Ramirez, Gabriela; Edwards, Matthew S.; Corriere, Matthew A.

doi:10.1016/j.jvs.2020.03.060

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…Fourteen studies assessed the effect of frailty on postoperative mortality. 26,27,29 –36,38 –41 Frailty and 30-day mortality were significant related ( p < 0.05). 26,27,29,30,36,39 The risk of 30-day mortality increased from 1.4 to 13.7 times in frail patients compared with nonfrail patients (OR, 1.4–13.7), except for those who underwent endovascular abdominal aortic aneurysm repair (EVAR) ( p = 0.36) and peripheral vascular surgeries ( p = 0.49).…”

Section: Resultsmentioning

confidence: 91%

“…32 The frailty phenotype model included grip strength measurement in one study. 41 The novel frailty markers included sarcopenia and the total psoas area in three studies. 33 –35 The deficit models provided better predictions of postoperative adverse outcomes and the likelihood of recovery than the frailty phenotype model and novel frailty markers.…”

Section: Resultsmentioning

confidence: 99%

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Frailty scoring in vascular and endovascular surgery: A systematic review

et al. 2022

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One in 10 independently living adults aged 65 years old and older is considered frail, and frailty is associated with poor postoperative outcomes. This systematic review aimed to examine the association between frailty assessments and postoperative outcomes in patients with vascular disease. Electronic databases – MEDLINE, Embase, and the Cochrane Library – were searched from inception until January 2022, resulting in 648 articles reviewed for potential inclusion and 16 studies selected. Demographic data, surgery type, frailty measure, and postoperative outcomes predicted by frailty were extracted from the selected studies. The risk of bias was assessed using the Newcastle–Ottawa Scale. The selected studies (mean age: 56.1–76.3 years) had low-to-moderate risk of bias and included 16 vascular (elective and nonelective) surgeries and eight frailty measures. Significant associations ( p < 0.05) were established between mortality (30-day, 90-day, 1-year, 5-year), 30-day morbidity, nonhome discharge, adverse events, failure to rescue, patient requiring care after discharge, and amputation following critical limb ischaemia. The strongest evidence was found between 30-day mortality and frailty. Composite 30-day morbidity and mortality, functional status at discharge, length of stay, spinal cord deficit, and access site complications were found to be nonsignificantly associated with frailty. With frailty being significantly associated with several adverse postoperative outcomes, preoperative frailty assessments can potentially be clinically useful in helping practitioners predict and guide the pre-, peri-, and postoperative management of frail with vascular disease.

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Section: Resultsmentioning

confidence: 91%

Section: Resultsmentioning

confidence: 99%

Frailty scoring in vascular and endovascular surgery: A systematic review

et al. 2022

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“…Low-HGS was a risk factor for postoperative complications identified in many studies [ 2 , 3 , 4 , 5 , 15 , 16 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Many studies have used skeletal muscle mass and grip strength to diagnose sarcopenia; however, Wang et al [ 4 ] compared patients with low-SMI who had high-HGS and those with low-HGS and found that major complications were significantly more frequent in the low-HGS group.…”

Section: Discussionmentioning

confidence: 99%

Impact of Preoperative Handgrip Strength on Postoperative Outcome after Radical Gastrectomy for Gastric Cancer Patients

Matsui

Inaki

Tsuji

et al. 2022

JCM

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In this study, we investigated whether preoperative low-handgrip strength (HGS) defined by the Asian working group for sarcopenia could be a predictor of postoperative outcomes in patients with gastric cancer. A total of 327 patients who underwent radical gastrectomy for c-stage I–III primary gastric cancer with pre-operative HGS records were included. The cut-off values of HGS were defined as 28 kg for males and 18 kg for females, with values below and above the cut-off defined as low-HGS and high-HGS, respectively. The primary outcome was infectious complications. We compared the postoperative outcomes of the groups after adjusting for the background using propensity score matching. Of the 327 patients, 246 (75.2%) and 81 (24.8%) were in the high and low-HGS groups, respectively. After adjusting for background, there were 57 patients in both groups. After matching, the low-HGS group had significantly more infectious complications (17.5% vs. 1.8%, p = 0.008). Multivariate analysis of infectious complications in the low-HGS group demonstrated chronic kidney disease and diabetes as independent risk factors (odds ratio 4.390, 95% confidence interval 1.120–17.20, p = 0.034). Preoperative low-HGS according to the Asian criteria was associated with infectious complications after gastrectomy. Chronic kidney disease and diabetes were independent risk factors for infectious complications among patients with low-HGS.

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“…Frailty is defined as a clinical state of vulnerability to endogenous and exogenous stressors that produces exacerbated outcomes when compared to non-frail counterparts [ 1 ]. It has been correlated with increased morbidity and mortality with exposure to stressors such as surgery [ 2 ]. Pre-operative frailty assessments in elderly patients have been used to predict adverse surgical outcomes, including prolonged hospital stay, all-cause mortality, morbidity, and discharge into skilled facilities instead of home [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…It has been correlated with increased morbidity and mortality with exposure to stressors such as surgery [ 2 ]. Pre-operative frailty assessments in elderly patients have been used to predict adverse surgical outcomes, including prolonged hospital stay, all-cause mortality, morbidity, and discharge into skilled facilities instead of home [ 2 , 3 ]. Furthermore, elderly patients with elevated frailty are more likely to experience death or disability after surgery [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The Utility of Grip Strength as a Simplified Measure of Frailty in the Older Adult in the Preoperative Clinic

Spiegowski¹,

Metzger²,

Jain³

et al. 2022

Cureus

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The aim of this study was to compare the measure of grip strength against other validated methods of measuring frailty. Materials and methodsThis was a single-center, cross-sectional study that took place at the Westchester Medical Center Pre-Procedural Testing Clinic. The patient population included n = 73 patients ≥65 years of age evaluated for elective surgery. During the study, patients' grip strength, CFS-I (Clinical Frailty Score of Investigator), CFS-P (Clinical Frailty Score of Participant), and FRAIL (Fatigue, Resistance, Aerobic capacity, Illnesses, and Loss of weight) scores were measured. ResultsGrip strength correlated negatively with the CFS-I, CFS-P, and FRAIL scores for females. Reduced grip strength in females correlated with higher frailty scores and vice versa. Male grip strength showed no significant relationship with the frailty scales. In addition, multivariate linear regression analysis revealed that the independent measure that demonstrated a significant inverse association with grip strength was age (β= -0.43, p = <0.001). ConclusionsThere exists a difference in the utility of grip strength as a measure of frailty between males and females.

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Outpatient grip strength measurement predicts survival, perioperative adverse events, and nonhome discharge among patients with vascular disease

Cited by 9 publications

References 16 publications

Frailty scoring in vascular and endovascular surgery: A systematic review

Frailty scoring in vascular and endovascular surgery: A systematic review

Impact of Preoperative Handgrip Strength on Postoperative Outcome after Radical Gastrectomy for Gastric Cancer Patients

The Utility of Grip Strength as a Simplified Measure of Frailty in the Older Adult in the Preoperative Clinic

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