Abstract
Background: Handgrip strength test quantifies the amount of static force that the hand can squeeze around a dynamometer and is associated with increased mortality in middle-aged and older adults, and in patients with chronic diseases. The prognostic role of handgrip strength in heart failure (HF) has not been fully investigated. Methods: A hydraulic hand dynamometer was used to measure handgrip strength in 317 outpatients with HF enrolled in The Atlanta Cardiomyopathy Consortium (TACC) cohort study. Patients repeated the test 3 times in each hand and the average from both hands was used. We defined poor handgrip strength based on age- and gender-specific normative data. We evaluated the association between poor handgrip strength and major clinical event (death, heart transplant, left ventricular assist device) and healthcare resource utilization. Results: Baseline patient characteristics are presented in Table 1; 228 patients (71.9%) had poor handgrip strength. Total follow-up was 911 patient-years; 55 patients (17.4%) experienced a major clinical event. There was a total of 836 all-cause hospitalizations with an average length of stay of 4.7 days. Poor handgrip strength was not significantly associated with major clinical events (hazard ratio (HR) 1,19; 95% CI: 0.64 to 2,21; P=0.59). However, patients with poor strength had 42% higher hospitalization rate (95% CI: 1.3% to 98%; P=0.042) and spent 85% (95% CI: 10% to 210%; P=0.020) more days in the hospital. Average length of stay among patients with poor handgrip strength was 4.9 days vs. 4.2 days in those with preserved strength. Conclusion: Poor handgrip strength is highly prevalent among HF patients and is associated with higher healthcare resource utilization and length of stay.
Published Version
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