Handgrip strength as a valid practical tool to screen early-onset sarcopenia in acute care wards: a first evaluation

Abstract

Sarcopenia is an age-related muscle disease associated with higher mortality, morbidity risk and health costs. An easy and convenient sarcopenia screening test would be hugely valuable for clinical critical care. The study aimed to assess handgrip strength (HGS) as a screening tool for sarcopenia in acute care-unit inpatients, using the EWGSOP 1 reference-standard definition. Inpatients, aged 75 years old or above, of two acute care wards—a multidisciplinary care unit (MCU) and a geriatric care unit (GCU), were included between September 2017 and June 2018 in a cross-sectional study. HGS, sarcopenia, nutritional status, functional status, number of medications and sociodemographic data were collected. The accuracy of HGS as a screening test for sarcopenia was assessed by gender using receiver operating characteristic (ROC) curves and area under the curve (AUC) in a population of older patients (n\u2009=\u2009223; age: 85.8\u2009yrs; BMI: 26.7\u2009kg/m²). Screening was positive (patients confirmed with sarcopenia by the HGS test) with cut-off values of 18\u2009kg for women and 25.5\u2009kg for men, with ROC analysis giving a sensitivity of 92.9% in women and 78.6% in men. ROC curve analysis found also that HGS should be strictly higher than 15\u2009kg in women and 18\u2009kg in men to maximise AUC. Prevalence of sarcopenia according to the EWGSOP1 definition was 31.8% (95% CI: 22.1–41.6%) in the MCU and 27.8% (95% CI: 19.6–36.0%) in the GCU. Acute care wards can use HGS as a valid, easy tool for early screening of sarcopenia. Handgrip strength is a valid and clinically practicable test, for screening early-onset sarcopenia during hospitalisation. Handgrip strength cut-off values of 18\u2009kg in women and 25.5\u2009kg in men gave 92.9% and 78.6% sensitivity, respectively. One-third of patients admitted to acute care wards have sarcopenia. Handgrip strength is a valid and clinically practicable test, for screening early-onset sarcopenia during hospitalisation. Handgrip strength cut-off values of 18\u2009kg in women and 25.5\u2009kg in men gave 92.9% and 78.6% sensitivity, respectively. One-third of patients admitted to acute care wards have sarcopenia.