Handgrip strength during admission for COPD exacerbation: impact on further exacerbation risk

BMC Pulm Med. 2021 Jul 21;21(1):245. doi: 10.1186/s12890-021-01610-7.

Abstract

Background: Low handgrip strength (HGS) is independently associated with a higher exacerbation risk in stable chronic obstructive pulmonary disease (COPD); however, the relationship between HGS while being admitted for COPD exacerbation and further exacerbation risk after discharge remains unclear.

Methods: We enrolled patients admitted for COPD exacerbation between January 2018 and June 2019. HGS tests were done within 3 days after admission. The primary endpoint was exacerbations within 12 months after the index admission, which needed emergency room visits or hospital admission. We analyzed the relationships among demographics, HGS, pulmonary function parameters, and acute exacerbation events.

Results: Among 43 enrolled patients, 31 (72.1%) participants (HGSw) had HGS weakness (22.1 ± 4.1 kg). The other 12 (27.9%) participants (non-HGSw) had the strength of handgrips 33.7 ± 3.1 kg. HGSw group showed a significantly higher rate of emergency room visits within 6, 9, and 12 months after the index admission than non-HGSw group (0.81 ± 1.30 vs. 0.08 ± 0.29, p = 0.045; 1.26 ± 1.59 vs. 0.17 ± 0.38, P = 0.019; 1.48 ± 1.86 vs. 0.25 ± 0.62, P = 0.027, respectively). There was a trend to have higher admission rate within 9 and 12 months in HGSw group, which did not achieve statistical significance (0.77 ± 1.38 vs. 0.08 ± 0.29, P = 0.064; 0.94 ± 1.56 vs. 0.08 ± 0.29, P = 0.062, respectively).

Conclusions: HGS weakness measured upon admission for COPD exacerbation was associated with a higher risk of exacerbation in the next year. Trial registration ClinicalTrials.gov Identifier: NCT04885933.

Keywords: Chronic obstructive pulmonary disease; Exacerbation; Handgrip strength.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Disease Progression
  • Female
  • Forced Expiratory Volume
  • Hand Strength / physiology*
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Muscle Weakness
  • Proportional Hazards Models
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Taiwan

Associated data

  • ClinicalTrials.gov/NCT04885933