Application of hand grip strength as a screening tool for frailty in patients with liver cirrhosis

Abstract

Objective To explore the cutoff points of handgrip strength and its predictive value in frailty assessment in hospitalised patients with cirrhosis. Methods By convenient sampling, the cirrhosis patients admitted to the Department of Gastroenterology of a ClassⅢ Grade A hospital from March 2017 to April 2018 were selected and studied. Fried frailty phenotype was used as the standard reference, and the receiver operating characteristic curve (ROC) was calculated to determine the best cutoff points of handgrip strength, hence evaluate its predictive value. Results A total of 80 questionnaires were distributed in which 73 valid ones were retrieved with a effective recovery rate of 91.25%. Among the patients, 40 patients (54.8%) were identified to be at frailty stage and 33 patients (45.2%) were in non-frailty stage; the handgrip strength was (19.72±3.50) kg, which had a negative correlation with age and neutrophil lymphocyte ratio (P<0.05) ; at the same time, it was positively correlated with serum albumin and walking speed (P< 0.05) . The area under the ROC curve of male and female cirrhosis patients was 0.734 and 0.863 respectively, and the optimal cut-off points were 18.95 kg and 15.03 kg; the sensitivity, specificity, positive predictive value and negative predictive value were 95.00%, 81.82%, 86.36%, and 93.10%. Conclusions When the grip strength of male and female patients were less than or equal to 18.95 kg and 15.03 kg respectively, it indicates that he or she is in a frailty state. Handgrip strength test can be a quick screening tool to identify frailty in inpatients with cirrhosis, and it has high predictive value, and is time-efficient, easy to use, therefore it can be applied in clinical practice. Key words: Liver cirrhosis; Frailty assessment; Handgrip strength; Cut-off point