Paediatric handgrip reference curves and the relationship between lower handgrip strength and clinical outcomes of hospitalised children.

Abstract

There is a need for population-based reference values of handgrip strength, which is an objective measurement reflecting muscle status, in the paediatric population and there is limited data on the prognostic importance of handgrip strength. The aim of the study was to establish reference percentiles for handgrip strength in healthy Turkish children and to investigate the relationship between handgrip strength and clinical outcomes in hospitalised children. A total of 1437 healthy children and 103 hospitalised children aged 6-16 years were included in this cross-sectional study. Healthy children were used for the development of sex-specific handgrip strength centiles adjusted for age and height using the Generalised Additive Models for Location, Scale and Shape package. Reference values of age and height specific handgrip strength of children between the ages of 6 and 16 were calculated and curves were plotted. Nutritional risk was assessed in the first 48 h of hospital admission using Paediatric Yorkhill Malnutrition Score. Of the hospitalised children, 32% were at medium risk and 46.6% were at high risk of malnutrition. Lower handgrip strength was 28.2% in the hospitalised children. High risk of malnutrition and lower handgrip strength increased the length of hospital stay in all regression models. The reference centiles for age- and height-specific handgrip strength, developed for the first time for Turkish children, will enable assessment and interpretation of muscle status. Lower handgrip strength is associated with longer hospital stay in hospitalised children.