Low grip strength predicts postoperative loss of independence in older adults undergoing hepatobiliary-pancreatic...

This study aimed to investigate the usefulness of preoperative assessment of grip strength and frailty in predicting surgical outcomes and loss of independence (LOI) after hepatobiliary-pancreatic (HBP) surgery among older adult patients.

This was a retrospective study that analyzed data of 224 older adults (≥70 years) who underwent HBP surgery for malignancies between June 2020 and May 2023. Grip strength and frailty assessment using a frailty checkup were assessed preoperatively at the first visit. LOI was defined as postoperative transfer for rehabilitation, readmission or mortality, new need for long-term health care, or an increase in the level of care within 6 months postoperatively.

Overall, 49 patients had reduced grip strength, and those with low grip strength were older and had poor nutritional status. Patients with low grip strength had a significantly longer postoperative hospital stay and higher complication and transfer rates than those with normal grip strength. The postoperative LOI was significantly high in patients with low grip strength (P <.001). According to the frailty checkup, low grip strength was significantly associated with falling and decreased frequency of going out. Multivariate analysis revealed that low grip strength was an independent risk factor for postoperative LOI (odds ratio, 7.24; P <.001). Exploratory risk factors for postoperative LOI included a low prognostic nutritional index, pancreatectomy, and low grip strength, and the LOI rate increased significantly as the number of risk factors increased.

Low grip strength may be a useful screening tool for predicting postoperative LOI in older adults undergoing HBP surgery.