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Nutrition in acute and chronic diseases

Reference values for handgrip strength and their association with survival in patients with incurable cancer

European Journal of Clinical Nutrition volume 76, pages 93–102 (2022)Cite this article

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Abstract

Background/Objectives

Handgrip strength (HGS) is a potential predictor of outcomes in cancer setting. However, reference values for this population are lacking. The study aimed to describe reference values and cutoff point for HGS in adults with incurable cancer in Brazil and to verify the association of reference values with prognostic.

Methods

Secondary analysis of a prospective cohort, conducted with 1,868 patients at the National Cancer Institute in Brazil were analyzed. HGS (kg) data were obtained with a Jamar® hydraulic dynamometer. Description of percentile values of HGS was stratified by sex and age groups. Receiver operating characteristic curve was performed to determine the optimal HGS cutoff point by sex and age according to performance status. Kaplan–Meier curves was used to analyze the probability of survival and Cox’s proportional model used to identify whether HGS predict 180-d mortality.

Results

HGS value was significantly higher in male than in female and decreased with increasing age. Sex-specific HGS cutoff values ranged from 32.5 to 24.5 kg in males and 20.5 to 18.5 kg in females (with younger adults stronger than the older ones). When compared to HGS ≥50th, patients with HGS ≤10th percentile had significantly lower survival, as well as patients classified below the HGS cutoff point. In addition, patients with lower HGS percentiles showed increased risk of mortality regardless of sex and age.

Conclusion

Reference values can inform the clinical assessment of HGS, which is recognized as an important part of the identification of patients with incurable cancer with reduced physical function and short survival.

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Fig. 1
Fig. 2: Kaplan–Maier survival curves are shown by handgrip strength (HGS).

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Authors and Affiliations

  1. Palliative Care Unit, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil

    Emanuelly Varea Maria Wiegert, Livia Costa de Oliveira & Larissa Calixto-Lima

  2. Continuing Education Course I, INCA, Rio de Janeiro, Brazil

    Naira Freire da Silva

Authors
  1. Emanuelly Varea Maria Wiegert
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  2. Naira Freire da Silva
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  3. Livia Costa de Oliveira
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  4. Larissa Calixto-Lima
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Contributions

EVMW, NFS, LCO, and LCL contributed to the conception and design of the research; EVMW, NFS, LCO, and LCL contributed to the acquisition and analysis of the data; EVMW, LCO, and LC, contributed to the interpretation of the data; and EVMW, LCL, and NFS drafted the paper. All authors have critically revised the paper, agree to be fully accountable for ensuring the integrity and accuracy of the work, and have read and approved the final paper.

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Correspondence to Emanuelly Varea Maria Wiegert.

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Wiegert, E.V.M., da Silva, N.F., de Oliveira, L.C. et al. Reference values for handgrip strength and their association with survival in patients with incurable cancer. Eur J Clin Nutr 76, 93–102 (2022). https://doi.org/10.1038/s41430-021-00921-6

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