Department of Geriatrics, La Paz University Hospital, Madrid, Spain.
Department of Geriatrics, La Paz University Hospital, Madrid, Spain.
Maturitas. 2020 Nov;141:20-25. doi: 10.1016/j.maturitas.2020.06.013. Epub 2020 Jun 18.
Muscle strength is a possible predictor of adverse events. It could have prognostic value in patients with hip fracture (HF). The aim of this study was to determine if handgrip strength is associated with functional impairment, readmissions, and mortality at one year in elderly patients with HF.
A prospective observational study was carried out. It included a cohort of patients aged 65 years or older with a diagnosis of fragility HF, consecutively from January 2013 to February 2014 and seen in follow-up at one year. Statistical analysis was performed using SPSS v21 software.
Five hundred and nine patients with a mean age of 85.4 ± 0.3 years were included, of whom 403 (79.2 %) were women. Clinical and functional outcomes, laboratory parameters and anthropometric measurements were collected.
Of the total sample, 339 (66.6 %) had reduced handgrip strength, and these patients were older, more frequently institutionalized, had poorer functional and cognitive status, higher comorbidity, higher surgical risk, lower body mass index and a greater intra-hospital mortality (all p < 0.01). At one year, patients with lower handgrip strength had a major change in their ability to walk (32.7 % vs. 10.9 %, p < 0.001) and a higher mortality rate (30.4 % vs. 8.8 %, p < 0.001). However, in patients over 91 years of age, there was no association between lower handgrip strength and change in ability to walk. There were no differences in the number of readmissions.
Low handgrip strength in elderly patients with HF predicts greater functional disability and higher long-term mortality.
肌肉力量是不良事件的一个可能预测因素。它可能对髋部骨折（HF）患者具有预后价值。本研究旨在确定握力是否与老年 HF 患者一年时的功能障碍、再入院和死亡率相关。
进行了一项前瞻性观察研究。纳入了 2013 年 1 月至 2014 年 2 月连续诊断为脆弱性 HF 的年龄在 65 岁或以上的患者队列，并在一年时进行了随访。使用 SPSS v21 软件进行统计分析。
共纳入 509 例平均年龄 85.4±0.3 岁的患者，其中 403 例（79.2%）为女性。收集了临床和功能结局、实验室参数和人体测量学测量值。
在总样本中，339 例（66.6%）握力降低，这些患者年龄较大、更多地住院、功能和认知状态较差、合并症更多、手术风险更高、身体质量指数较低、院内死亡率更高（均 p<0.01）。在一年时，握力较低的患者行走能力发生了较大变化（32.7%对 10.9%，p<0.001），死亡率更高（30.4%对 8.8%，p<0.001）。然而，在 91 岁以上的患者中，握力较低与行走能力变化之间没有关联。再入院人数没有差异。
HF 老年患者握力较低预示着更大的功能障碍和更高的长期死亡率。
