Reference values for handgrip strength and their association with survival in patients with incurable cancer

Handgrip strength (HGS) is a potential predictor of outcomes in cancer setting. However, reference values for this population are lacking. The study aimed to describe reference values and cutoff point for HGS in adults with incurable cancer in Brazil and to verify the association of reference values with prognostic.

Secondary analysis of a prospective cohort, conducted with 1,868 patients at the National Cancer Institute in Brazil were analyzed. HGS (kg) data were obtained with a Jamar^® hydraulic dynamometer. Description of percentile values of HGS was stratified by sex and age groups. Receiver operating characteristic curve was performed to determine the optimal HGS cutoff point by sex and age according to performance status. Kaplan-Meier curves was used to analyze the probability of survival and Cox's proportional model used to identify whether HGS predict 180-d mortality.

HGS value was significantly higher in male than in female and decreased with increasing age. Sex-specific HGS cutoff values ranged from 32.5 to 24.5 kg in males and 20.5 to 18.5 kg in females (with younger adults stronger than the older ones). When compared to HGS ≥50th, patients with HGS ≤10th percentile had significantly lower survival, as well as patients classified below the HGS cutoff point. In addition, patients with lower HGS percentiles showed increased risk of mortality regardless of sex and age.

Reference values can inform the clinical assessment of HGS, which is recognized as an important part of the identification of patients with incurable cancer with reduced physical function and short survival.