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

Frontiers in Nutrition

Tao Xu¹  Xiao-Ming Zhang²  Na Guo²  Ying Liu²  Chen Zhu²  Jing Jiao²  Xinjuan Wu²  Shengxiu Zhao³  Xianxiu Wen⁴  Dongmei Lv⁵  Jingfen Jin⁶  Hui Wang⁷ 

[1] Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China;Department of Nursing, Chinese Academy of Medical Sciences—Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China;Department of Nursing, Qinghai Provincial People's Hospital, Xining, China;Department of Nursing, Sichuan Provincial People's Hospital, Chengdu, China;Department of Nursing, The Second Affiliated Hospital of Harbin Medical University, Harbin, China;Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;

关键词: handgrip strength;    older adults;    mortality;    inpatient;    cohort study;   

DOI  :  10.3389/fnut.2021.628628

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown