Can early assessment of hand grip strength in older hip fracture patients predict functional outcome?

PLoS One. 2019 Aug 1;14(8):e0213223. doi: 10.1371/journal.pone.0213223. eCollection 2019.

Abstract

Decreased muscle strength is not only a risk factor for hip fracture in older patients, but plays a role in recovery of physical function. Our aim was to assess the role of grip strength measured early after hip fracture, and classified according to the EWGSOP2 criteria in predicting short- and long-term functional recovery. One hundred ninety-one patients with acute hip fracture consecutively admitted to an orthopaedic hospital have been selected. A multidimensional geriatric assessment evaluating sociodemographic variables, cognitive status, functional status and quality of life prior to fracture, as well as perioperative variables were performed. Follow-ups at 3 and 6 months after surgery were carried out to evaluate functional recovery. Multivariate regression models were used to assess the predictive role of handgrip strength. The mean age of the participants was 80.3 ±6.8 years. Thirty-five percent of our patients with clinically relevant hand grip strength weakness were significantly older, more often female, had a lower BMI, and were of worse physical health. They also had a lower cognitive level, lower Barthel index, and lower EQ5D scores before fracture. Multivariate regression analysis adjusted for age and gender revealed that hand grip weakness was an independent predictor of worse functional outcome at 3 and 6 months after hip fracture for both genders and in all age populations. Our study supports the prognostic role of hand grip strength assessed at hospital admission in patients with hip fracture. Thus, clinicians should be encouraged to include hand grip assessment in their evaluation of hip fracture patients in the acute setting in order to optimize treatment of high-risk individuals.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Geriatric Assessment / methods*
  • Hand / physiopathology*
  • Hand Strength / physiology*
  • Hip Fractures / physiopathology*
  • Humans
  • Male
  • Quality of Life*
  • Recovery of Function*
  • Treatment Outcome

Grants and funding

This work has been done as a part of project of Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja (Ministry of Education, Science and Technological Development of the Republic of Serbia) Project number is 175046, and it lasts from 2011 to 2020. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.