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Utility of Hand Grip Strength in Predicting Mortality Risk in Chronic Limb-Threatening Ischemia
Kirsten G Goves1, Amirah Essop-Adam2, Imelda Black2
1Department of Cardiovascular Sciences, University of Leicester, Leicester.
Annals of Vascular Surgery
|July 3, 2026
Summary
Low hand grip strength, a sign of sarcopenia, is linked to worse survival in patients with chronic limb-threatening ischemia (CLTI). This simple test can help predict mortality risk in CLTI patients.
Area of Science:
- Vascular Surgery
- Geriatrics
- Clinical Nutrition
Background:
- Chronic limb-threatening ischemia (CLTI) carries a high mortality risk, up to 50% at five years.
- Sarcopenia, characterized by low muscle strength, quantity, and quality, is linked to adverse health outcomes.
- The prognostic value of sarcopenia, assessed via hand grip strength, in CLTI patients requires further investigation.
Purpose of the Study:
- To investigate the association between sarcopenia, identified by hand grip strength, and two-year mortality in patients with CLTI.
Main Methods:
- A single-centre prospective cohort study included 97 patients undergoing CLTI procedures.
- Hand grip strength was measured using a digital dynamometer; sarcopenia was defined as <16kg (women) or <27kg (men).
- Cox regression analysis, adjusted for confounders, assessed the association with two-year mortality.
Main Results:
- 26% of participants had sarcopenia, were older, and had more severe CLTI, frailty, and comorbidities.
- At two years, 26% of patients died, with 68% of these deaths occurring in the sarcopenia group.
- Sarcopenia was independently associated with a significantly higher risk of two-year mortality (HR 6.4, 95% CI 2.4-17.2).
Conclusions:
- Hand grip strength is a strong predictor of two-year survival in CLTI patients.
- Grip strength measurement can serve as a valuable tool for risk stratification.
- This simple assessment can aid in shared decision-making for CLTI management.
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