Handgrip strength and adductor pollicis muscle thickness as predictors of postoperative complications after major operations of the gastrointestinal tract

Abstract

summary Background & Aims: Malnutrition increases the risk of postoperative complications. We investigated whether handgrip strength (HGS) and adductor pollicis muscle (TAPM) thickness are reliable indicators of postoperative outcome in patients undergoing major abdominal operations. Methods: A prospective cohort study was conducted that involved 90 patients who underwent major digestivetract surgery.All patientsweresubjectedtoanthropometric measurements and subjectiveglobal assessment. Both HGS and TAPM were analyzed as potential risk factors for postoperative outcome. Results: TAPM was significantly correlated with all anthropometric measurements (p < 0.001). Multivariate linear regression analysis indicated that both HGS and TAPM were significantly greater in male, nourished, and younger patients. The relative risk (RR) of postoperative death was approximately fivefold higher (RR ¼ 5.01; 95% confidence interval [CI]: 1.79e14.03; p < 0.001) in patients with abnormal HGS and approximately 25% greater in patients with abnormal TAPM (RR ¼ 1.26; 95% CI: 1.03e1.55; p ¼ 0.02). Abnormal HGS increased the risk of either infectious (RR ¼ 1.53; 95% CI: 1.06e2.21; p ¼ 0.01) or noninfectious (RR ¼ 1.45; 95% CI: 1.02e2.06; p ¼ 0.02) complications by 50%. Abnormal TAPM was associated with an increased number of complications. The length of postoperative hospital stay was greater in patients with abnormal HGS (p ¼ 0.02).