Value of handgrip strength to predict clinical outcomes and therapeutic response in malnourished medical inpatients: Secondary analysis of a randomized controlled trial
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Background Disease-related malnutrition is associated with loss of muscle mass and impaired functional status. Handgrip strength (HGS) has been proposed as an easy-to-use tool to assess muscle strength in clinical practice. Objectives We investigated the prognostic implications of HGS in patients at nutritional risk with regard to clinical outcomes and response to nutritional support. Methods This was a secondary analysis of the randomized controlled, multicenter, Effect of Early Nutritional Support on Frailty, Functional Outcome, and Recovery of Malnourished Medical Inpatients Trial, which compared the effects of individualized nutritional support with usual hospital food in medical inpatients at nutritional risk. Our primary endpoint was 30-d all-cause mortality. The association between sex-specific HGS and clinical outcomes was investigated using multivariable regression analyses, adjusted for randomization, age, weight, height, nutritional risk, admission diagnosis, comorbidities, interaction terms, and study center. We used interaction terms to investigate possible effect modification regarding the nutritional support intervention. Results Mean ± SD HGS in the 1809 patients with available handgrip measurement was 17.0 ± 7.1 kg for females and 28.9 ± 11.3 kg for males. Each decrease of 10 kg in HGS was associated with increased risk of 30-d mortality (female: adjusted OR: 2.11; 95% CI: 1.23, 3.62, P = 0.007; male: adjusted OR: 1.44; 95% CI: 1.07, 1.93, P = 0.015) and 180-…
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Handgrip strength is a useful indicator of general health status and, specifically, of early mortality from any cardiovascular cause, as well as disability.
“HGS is a useful indicator of general health status and, specifically, of early mortality from any cardiovascular cause, as well as disability [110,111].”
From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [111]
Some studies suggest that low muscle strength measured by handgrip strength is a predictor for response to nutritional treatment.
“There are several studies looking at biomarkers of muscle strength and/or function with some suggesting that low muscle strength measured by HGS is a predictor for response [134] (Level of evidence 1þþ) while others found sarcopenia to be a predictor of non-response in mixed populations [165,188].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [134]
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- Authors
- Kaegi-Braun, N., Tribolet, P., Baumgartner, A., Fehr, R., Baechli, V., Geiser, M., Deiss, M., Gomes, F., Kutz, A., Hoess, C., Pavlicek, V., Schmid, S., Bilz, S., Sigrist, S., Brändle, M., Benz, C., Henzen, C., Thomann, R., Rutishauser, J., Aujesky, D., Rodondi, N., Donzé, J., Stanga, Z., Mueller, B., & Schuetz, P.
- Affiliations
- Kantonsspital Aarau (CH)
- University of Vienna (AT)
- New York Academy of Sciences (US)
- University of Basel (CH)
- Kantonsspital Münsterlingen (CH)
- Kantonsspital St. Gallen (CH)
- Luzerner Kantonsspital (CH)
- Kantonsspital Baselland (CH)
- University of Bern (CH)
- ORCID
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2021-08
- Volume
- 114
- Issue
- 2
- Pages
- 731-740
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W3152464910
- Cited by
- 67
- References
- 35
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 18 · 2023: 16 · 2022: 15 · 2021: 5
- FWCI
- 8.47
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-08-01)
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion, other-oa)
- Open Access CRIS of the University of Bern
- Funders
- Swiss National Science Foundation
- Research Council of Kantonsspital Aarau
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- grip strength, disease-related malnutrition, nutritional risk, individualized nutritional support, 30-day mortality, 180-day mortality, prognostic factors, muscle strength, frailty, functional outcome, medical inpatients, sex differences, effect modification, hospital food
- MeSH terms
- Aged, Aged, 80 and over, Female, Hospitalization, Humans, Inpatients, Male, Middle Aged, Nutritional Status, Nutrition Assessment, Odds Ratio, Treatment Outcome, Nutritional Support, Hand Strength, Malnutrition, Nutrition Therapy
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