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Cutoff points for handgrip strength in patients with liver cirrhosis: a multicenter study
Bárbara Chaves Santos1, Bruna Cherubini Alves2, Ana Luisa Ferreira Fonseca3
1Food Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Insights
Handgrip strength (HGS) cutoff points can predict 1-year mortality in liver cirrhosis patients. Low HGS in men and women, stratified by age, indicates increased mortality risk.
Area of Science:
- Hepatology and Gastroenterology
- Clinical Medicine
- Geriatrics
Background:
- Liver cirrhosis is a significant cause of mortality worldwide.
- Accurate prognostic markers are crucial for managing cirrhotic patients.
- Handgrip strength (HGS) is an emerging indicator of overall health and frailty.
Purpose of the Study:
- To establish specific handgrip strength (HGS) cutoff points for predicting 1-year mortality in adult liver cirrhosis patients.
- To stratify these HGS cutoff points by sex and age groups.
- To evaluate the association between low HGS and mortality risk in this population.
Main Methods:
- Analysis of a cohort database from four Brazilian reference centers.
- Inclusion of adult patients (≥18 years) diagnosed with liver cirrhosis.
- Determination of optimal HGS cutoff values using sensitivity and specificity analyses, stratified by sex and age, and validated with Cox regression models.
Main Results:
- The study included 724 patients with cirrhosis; 18.5% died within 1 year.
- Defined HGS cutoff points: men <60 years ≤33 kgf, women <60 years ≤12 kgf; men ≥60 years ≤22 kgf, women ≥60 years ≤10 kgf.
- Low HGS was significantly associated with a 2.5-fold increased risk of 1-year mortality.
Conclusions:
- The identified HGS cutoff points serve as valuable tools for risk stratification in liver cirrhosis.
- These HGS values can help clinicians identify patients at higher risk of 1-year mortality.
- Implementing HGS assessment can improve patient management and prognostication in liver cirrhosis care.
Objectives:
This study aimed to define handgrip strength (HGS) cutoff points to predict 1-year mortality in adult patients with liver cirrhosis.
Methods:
This is an analysis of cohort databases from four reference centers in Brazil. Inpatients or outpatients with cirrhosis and aged ≥18 years were included. The best cutoff values of HGS (highest value from three attempts with the non-dominant hand) for predicting 1-year mortality, stratified by sex and age, were established based on the sensitivity and specificity analyses. Adjusted Cox regression models were used to test the predictive value of low HGS.
Results:
The study included 724 patients with cirrhosis, with a median age of 57.0 years (IQR: 50.0-63.0), 66.4% (n = 481) male. Most patients had alcoholic cirrhosis (n = 281; 38.8%), 400 (55.3%) were classified as Child-Pugh B or C, and 134 (18.5%) patients died after 1-year. The HGS cutoffs were ≤33 kgf and ≤12 kgf for men and women aged <60 years, respectively, and ≤22 kgf and ≤10 kgf for older men and women, respectively (sensitivity: 70.9%; specificity: 61.2%). Low HGS was associated with a 2.5-fold increase in the risk of 1-year mortality.
Conclusion:
These cutoff points could be used to identify patients with a higher mortality risk.
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