Savino E, Sioulis F, Guerra G, Cavalieri M, Zuliani G, Guralnik J M, Volpato S
Stefano Volpato, MD, MPH, Department of Clinical and Experimental Medicine, University of Ferrara, Via Savonarola, 9, I-44100 Ferrara, ITALY, e-mail
J Frailty Aging. 2012;1(1):32-8. doi: 10.14283/jfa.2012.6.
Objective measures of physical function are useful prognostic tools also for hospitalized elders. Low handgrip strength is predictive of poor outcomes and it can be assessed also in a sitting position, representing a potential alternative measure in bedridden patients. We evaluated grip strength prognostic value in hospitalized older patients.
Prospective cohort study.
Geriatric, medical ward of an academic medical center in Ferrara, Italy.
Patients aged 65 and older (N = 88) admitted to the hospital for an acute medical condition.
Patients were evaluated for grip strength at hospital admission and were re-evaluated at discharge. After discharge, they were followed every 3 months for 1 year by telephone interviews to assess new hospitalizations and vital status.
The mean age of the sample was 77.3 years, 47% were women. At admission, mean height standardized handgrip strength was 15.7±5 kg/m; men had greater strength (p<0.001). There was a direct relationship of admission grip strength with BMI (p<0.05), serum albumin (p=0.07), and Short Physical Performance Battery score (p<0.05), and an inverse relationship with age (gender-adjusted p value <0.01). In multiple regression analysis, after adjustment for possible confounders, patients in third tertile of grip strength had a shorter hospital stay compared to those in the first tertile (β -2.8; p<0.05). Patients with higher grip strength at discharge also had a lower risk of rehospitalization or death over the follow-up, although the result was not statistically significant (OR: 0.68; 95% CI: 0.30-1.52).
In older hospitalized medical patients, grip strength assessment might provide useful prognostic information.
身体功能的客观测量指标对于住院老年人也是有用的预后工具。握力低预示着不良预后，并且也可以在坐姿下进行评估，这对于卧床患者来说是一种潜在的替代测量方法。我们评估了住院老年患者握力的预后价值。
前瞻性队列研究。
意大利费拉拉一家学术医疗中心的老年医学内科病房。
因急性疾病入院的65岁及以上患者（N = 88）。
患者在入院时接受握力评估，并在出院时重新评估。出院后，通过电话访谈每3个月对他们进行1年的随访，以评估再次住院情况和生命状态。
样本的平均年龄为77.3岁，47%为女性。入院时，平均身高标准化握力为15.7±5 kg/m；男性握力更强（p<0.001）。入院时的握力与BMI（p<0.05）、血清白蛋白（p = 0.07）和简短体能状况量表评分（p<0.05）呈正相关，与年龄呈负相关（性别调整p值<0.01）。在多元回归分析中，在对可能的混杂因素进行调整后，握力处于第三个三分位数的患者与处于第一个三分位数的患者相比，住院时间更短（β -2.8；p<0.05）。出院时握力较高的患者在随访期间再次住院或死亡的风险也较低，尽管结果无统计学意义（OR：0.68；95% CI：0.30 - 1.52）。
在老年住院内科患者中，握力评估可能提供有用的预后信息。
