Witt et al evaluated handgrip strength as a predictor of hospital readmission following an admission for an acute exacerbation of COPD. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of California San Francisco, Brigham and Women's Hospital and the University of Chicago.
Patient selection: hospital admission for an acute exacerbation of COPD; ages were from 55 to 72 years.
Outcome: all-cause 30-day readmission (most are not due to COPD or respiratory-related)
Weak handgrip strength was associated with increased risk for readmission, using the cut-offs of Fried et al used to determine frailty.
Parameters:
(1) sex
(2) body mass index in kg per square meter
(3) handgrip strength in kilograms
Sex
Body Mass Index
Handgrip
At Risk
male
<= 24
> 29 kg
No
<= 24
<= 29 kg
Yes
24.1 to 28
> 30 kg
No
24.1 to 28
<= 30 kg
Yes
> 28
> 32 kg
No
> 28
<= 32 kg
Yes
female
<= 23
> 17 kg
No
<= 23
<= 17 kg
Yes
23.1 to 26
> 17.3 kg
No
23.1 to 26
<= 17.3 kg
Yes
26.1 to 29
> 18 kg
No
26.1 to 29
<= 18 kg
Yes
> 29
> 21 kg
No
> 29
<= 21 kg
Yes
If the handgrip was weak, then the patient was at increased risk for 30-day readmission (OR 11.2).
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