Relation of anthropometric and dynamometric variables to serious postoperative complications.

Klidjian, A.; Foster, K. J.; Kammerling, R. M.; Cooper, Arthur; Karran, S. J.

doi:10.1136/bmj.281.6245.899

Cited by 264 publications

(87 citation statements)

References 7 publications

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“…The HGS results observed in our sample are considerably lower than those reported in other studies carried out with hospital patients (Klidjian et al, 1980;Klidjian et al, 1982) and healthy subjects (Luna-Heredia et al, 2005;Frederiksen et al, 2006). Grip strength distribution of our sample shows a large proportion of patients with zero or extremely low values.…”

Section: Discussioncontrasting

confidence: 89%

“…As expected, improved performance of HGS as a screening method was found for the patients with lower strength (allocated in the first quartile) with higher sensitivity than specificity and also with higher negative predictive values, than when higher cutoff values for HGS (second and third quartiles) were used. This diagnostic value of HGS against NRS-2002 was comparable with some studies carried out in surgical patients using HGS vs more detailed nutritional assessment (Klidjian et al, 1980(Klidjian et al, , 1982Hunt et al, 1985;Kalfarentzos et al, 1989;Webb et al, 1989). The diagnostic value of HGS against NRS-2002 was comparable to that of NRS-2002 and other tools for nutritional screening and assessment at hospital admission (Kyle et al, 2005a;Valero et al, 2005).…”

Section: Discussionsupporting

confidence: 71%

“…The simplicity and ease required to apply HGS as a nutritional screening method, contrasts with other screening tools, which require skilled personnel. Previous studies carried out among restricted groups of patients showed that HGS has one main requirement of a nutritional status screening test, the ability to detect undernutrition (Klidjian et al, 1980;Klidjian et al, 1982;Lopes et al, 1982;Windsor and Hill, 1988;Kalfarentzos et al, 1989;Webb et al, 1989;Vaz et al, 1996;Humphreys et al, 2002). The absence of previous reports about the performance of HGS as an undernutrition screening tool in a wide range of diagnosis, justified the evaluation of its effectiveness.…”

Section: Discussionmentioning

confidence: 99%

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Handgrip strength as a hospital admission nutritional risk screening method

2007

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Objective: To investigate if handgrip strength (HGS) could be used as a single screening procedure in identifying patients who are classified as being undernourished or nutritionally-at-risk at hospital admission. Design: Cross-sectional study. In the second day of hospital admission, HGS was evaluated and results were compared with Nutritional Risk Screening (NRS-2002). Setting: Two public hospitals in Porto, Portugal, a university and a district one. Subjects: A probabilistic sample of 50% in-patients from each hospital of 314 patients (age range of 18-96) was studied. Patients were considered eligible if they were X18 years old and able to give informed consent. Hand pain, upper limb deformities, incapacity to perform muscle strength measurements and pregnancy were considered further exclusion criteria. Results: Patients identified as undernourished by NRS-2002 (37.9%) were older, shorter and lighter, with a lower functional capacity, a longer length of stay and a lower HGS (Po0.001). When comparing patients with lower HGS (first quartile) with those with the highest HGS (fourth quartile), this parameter revealed good sensitivity (86.7%) and specificity (70.2%) and a k ¼ 0.56. Multivariate analysis showed that patients with higher HGS had an independent decreased risk of being at nutritional risk (P for trend o0.001) odds ratio ¼ 0.19 (95% confidence interval ¼ 0.08-0.48). Our entire sample of hospitalized patients was À1.96 Z-score below the HGS cutoff of distribution data for healthy individuals. Conclusions: HGS identifies a high proportion of nutritionally-at-risk patients and can be a reliable first screening tool for nutritional risk in hospitals. Sponsorship: Fundação Ilídio Pinho and Reitoria of the University of Porto -Programa Investigação Científica na Pré-graduação.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

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Handgrip strength as a hospital admission nutritional risk screening method

2007

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“…Increasing values re¯ect a slowing of reaction time as a measure of central fatigue. (4) Grip strength (GS) readings (Klidjian et al, 1980) were taken from the non-dominant arm of the subject using a Takei T.K.K 5001 dynamometer. Tests were made with the subject standing and with the arm straight and by their side.…”

Section: Testsmentioning

confidence: 99%

Post-prandial changes in measures of fatigue: Effect of a mixed or a pure carbohydrate or pure fat meal

1997

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Objectives: To assess the changes in measures of fatigue after meals of varying composition, and to compare the relation of the fatigue with changes in the plasma tryptophan:large neutral amino acids (Trp:LNAA) ratio. Subjects: Sixteen healthy volunteers were recruited from staff and students at the College. Design: Subjects were tested for central and peripheral fatigue using a visual analogue scale,¯icker fusion frequency, grip strength, reaction time and wrist ergometry. In addition, plasma amino acid concentrations and Trp:LNAA ratio were determined. Measurements were made before, and at 1, 2, 3 and 4 h after drinking one of three liquid test meals. The meals were isoenergetic (1672 kJ) and were of mixed carbohydrate, fat and protein, or of pure carbohydrate or pure fat. Setting: Department of Human Nutrition. Results: Subjects consuming the pure carbohydrate meal reported more subjective feelings of fatigue and had slower reaction times. Aspects of central fatigue were greater in subjects consuming a pure fat meal. The Trp:LNAA ratio was depressed in those consuming a pure fat or mixed meal and raised only after pure carbohydrate. Conclusions: Central and subjective fatigue may be in¯uenced by raised plasma free tryptophan to competitor amino acid ratios induced by carbohydrate intake but other aspects of central arousal are affected by fat intake.

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“…Associations have been reported between poor nutritional status and impaired wound healing (Haydock & Hill, 1986), higher post-operative infection risk Detsky et al 1987a;Bashir et al 1990;Sagar & MacFie, 1994;Giner et al 1996), impaired quality of life (Larsson et al 1994), and adverse effects on the functioning of the gastrointestinal tract , immune (Christou, 1990;Ek et al 1990;Welsh et al 1996), cardiovascular (Heymsfield et al 1978) and respiratory (Arora & Rochester, 1982) systems. In addition, associations have been reported between pre-operative weight loss and both increased post-operative complications (Studley, 1936;Klidjian et al 1980;Meguid et al 1988;Reilly et al 1988;Windsor & Hill, 1988;Von Meyenfeldt et al 1992) and increased post-operative mortality Giner et al 1996). These adverse effects can result in longer postoperative convalescence times (Bastow et al 1983;Lumbers et al 1996) and increased duration of hospital stay (Bastow et al 1983;Shaw-Stiffel et al 1993).…”

Section: Consequences Of Undernutritionmentioning

confidence: 99%

Pre-operative nutritional assessment

Corish

1999

Proc. Nutr. Soc.

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Protein-energy undernutrition, or the possibility of its development, has been documented to occur frequently in surgical patients admitted to hospital. Nutritional status is known to deteriorate over the course of the hospital stay, with poor awareness by medical and nursing staff as to the deleterious effects of impaired nutritional status on clinical outcome and hospital costs. While there is no consensus on the best method for assessment of the nutritional status of surgical patients pre-operatively, there are a number of techniques available. These techniques can be divided into two types, those suitable for screening for nutrition risk on admission to hospital and those used to fully assess nutritional status. Both techniques have their limitations, but if used correctly, and their limitations recognized, should identify the appropriate degree of nutritional intervention for an individual patient in a timely and cost-effective manner. The techniques currently available for nutritional screening and nutritional assessment are reviewed, and their applicability to the Irish setting are discussed in the present paper.

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Relation of anthropometric and dynamometric variables to serious postoperative complications.

Cited by 264 publications

References 7 publications

Handgrip strength as a hospital admission nutritional risk screening method

Handgrip strength as a hospital admission nutritional risk screening method

Post-prandial changes in measures of fatigue: Effect of a mixed or a pure carbohydrate or pure fat meal

Pre-operative nutritional assessment

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