A prospective study of hand grip strength and cardiovascular outcomes in a cardiovascular intensive care unit

Binaya Basyal¹Harris Jarrett²Neha Gupta²Phillip Nelson²Evan Czulada²Alexandra A Taylor³Caroline E Adams³Allen Taylor^1*

• ¹MedStar Heart & Vascular Institute, Fairfax, United States
• ²MedStar Health Cardiology at MedStar Washington Hospital Center, Washington, United States
• ³Georgetown University, Washington, United States

Background: Handgrip strength (HGS) is a marker of frailty that is associated with major adverse cardiovascular outcomes. The relationship between HGS and outcomes in a cardiovascular intensive care unit (CVICU) setting has not been previously studied. Objectives: Methods: We measured handgrip strength upon admission to the CVICU among 330 consecutive adult patients. Subsequent clinical outcomes of interest included readmission to the CVICU, CVICU and hospital length of stay (LOS), 30-day hospital readmission, and in-hospital mortality. Mean values were compared using the student t-test and Pearson's r was used to test bivariate correlation. Results: 330 patients underwent HGS assessment. HGS was significantly inversely correlated with hospital LOS (r = -0.165, P = 0.003) and mean LOS was 3 days longer among the lowest quartile (HGS <18 kg; P = 0.049). HGS was not associated with either CVICU or 30-day readmission and mortality. Among non-procedural admissions to the CVICU, linear regression identified HGS, age, and albumin as significant predictors of hospital LOS (r = 0.38; P < 0.001). Following an elective procedure, the Oxford Acute Severity of Illness Score (OASIS) score (r = 0.426, P < 0.001) and albumin (r = -0.380, p <0.001) were better predictors of LOS than HGS. Conclusions: Hand grip strength provides a simple point of care assessment in the CVICU for determination of patient frailty. Lower values are independently associated with hospital length of stay among non-procedural patients.