Evaluating Repeated Handgrip Strength Measurements As Predictors Of Mortality In Malnourished Hospitalized Patients – Secondary Analysis Of A Randomized Controlled Trial

Introduction: Handgrip strength (HGS) is a simple yet effective bed-side tool for assessing muscle strength, which plays an important role in clinical evaluation and monitoring.

Objectives: Although a single measurement of HGS at baseline provides information about a patient's current condition, we propose that repeated HGS assessments could serve as a more reliable indicator of clinical course and outcomes.

Methods: We re-analyzed data from 565 out of 2,028 patients who had repeated handgrip measurement (on admission and on day 7) included in EFFORT, a Swiss-wide multicenter, randomized controlled trial comparing individualized nutritional support with usual care nutrition in medical inpatients. The primary endpoint was 180-day all-cause mortality.

Results: The mean change in HGS from baseline to day 7 was 0.6 kg (SD 4.2) in female and 0.7 kg (SD 3.7) in male patients. Patients with a positive HGS trend had a lower risk of dying within 180 days (adjusted HR 0.45 [95% CI 0.27 to 0.77], p=0.003). The change in HGS was also associated with the nutritional intake during the hospitalization in male patients: those who met their energy and protein targets were twice as likely to have an increase in HGS during hospitalization (adjusted OR 2.05 [95% CI 1.23 to 3.42], p=0.006).

Conclusion: Achieving nutritional targets was associated with a short-term increase in HGS during hospitalization, and a positive HGS trend was associated with a lower risk of mortality after 180 days. These data provide evidence that repeated HGS measurements are a robust bedside tool for assessing and monitoring patients receiving nutritional therapy in hospital.

Publication History

Article published online:
25 May 2025