Preoperative muscle weakness as defined by handgrip strength and postoperative outcomes: a systematic review

BMC Anesthesiology

Research Article

Mark A Hamilton¹  Gareth L Ackland²  Pervez Sultan³ 

[1] Anaesthesia and Critical Care, St Georges Hospital NHS Trust, London, UK;Centre for Anaesthesia, Critical Care and Pain Management, University College London, London, UK;Department of Medicine, University College London, London, UK;Department of Anesthesia, Stanford University Medical Center, 94305, Stanford, California, USA;

关键词: Maximal Voluntary Contraction;    Grip Strength;    Postoperative Outcome;    Postoperative Morbidity;    Handgrip Strength;   

DOI  :  10.1186/1471-2253-12-1

 received in 2011-05-23, accepted in 2012-01-17,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundReduced muscle strength- commonly characterized by decreased handgrip strength compared to population norms- is associated with numerous untoward outcomes. Preoperative handgrip strength is a potentially attractive real-time, non-invasive, cheap and easy-to-perform "bedside" assessment tool. Using systematic review procedure, we investigated whether preoperative handgrip strength was associated with postoperative outcomes in adults undergoing surgery.MethodsPRISMA and MOOSE consensus guidelines for reporting systematic reviews were followed. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Clinical Trials (1980-2010) were systematically searched by two independent reviewers. The selection criteria were limited to include studies of preoperative handgrip strength in human adults undergoing non-emergency, cardiac and non-cardiac surgery. Study procedural quality was analysed using the Newcastle-Ottawa Quality Assessment score. The outcomes assessed were postoperative morbidity, mortality and hospital stay.ResultsNineteen clinical studies (17 prospective; 4 in urgent surgery) comprising 2194 patients were identified between1980-2010. Impaired handgrip strength and postoperative morbidity were defined inconsistently between studies. Only 2 studies explicitly ensured investigators collecting postoperative outcomes data were blinded to preoperative handgrip strength test results. The heterogeneity of study design used and the diversity of surgical procedures precluded formal meta-analysis. Despite the moderate quality of these observational studies, lower handgrip strength was associated with increased morbidity (n = 10 studies), mortality (n = 2/5 studies) and length of hospital stay (n = 3/7 studies).ConclusionsImpaired preoperative handgrip strength may be associated with poorer postoperative outcomes, but further work exploring its predictive power is warranted using prospectively acquired, objectively defined measures of postoperative morbidity.

【 授权许可】

Unknown   
© Sultan et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.