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Protein, malnutrition and wasting diseases

Handgrip strength measurement as a predictor of hospitalization costs

European Journal of Clinical Nutrition volume 69, pages 187–192 (2015)Cite this article

Subjects

Abstract

Background:

Undernutrition status at hospital admission is related to increased hospital costs. Handgrip strength (HGS) is an indicator of undernutrition, but the ability of HGS to predict hospitalization costs has yet to be studied.

Objective:

To explore whether HGS measurement at hospital admission can predict patient's hospitalization costs.

Subjects/Methods:

A prospective study was conducted in a university hospital. Inpatient's (n=637) HGS and undernutrition status by Patient-Generated Subjective Global Assessment were ascertained. Multivariable linear regression analysis, computing HGS quartiles by sex (reference: fourth quartile, highest), was conducted in order to identify the independent predictors of hospitalization costs. Costs were evaluated through percentage deviation from the mean cost, after adjustment for patients' characteristics, disease severity and undernutrition status.

Results:

Being in the first or second HGS quartiles at hospital admission increased patient's hospitalization costs, respectively, by 17.5% (95% confidence interval: 2.7–32.3) and 21.4% (7.5–35.3), which translated into an increase from €375 (58–692) to €458 (161–756). After the additional adjustment for undernutrition status, being in the first or second HGS quartiles had, respectively, an economic impact of 16.6% (1.9–31.2) and 20.0% (6.2–33.8), corresponding to an increase in hospitalization expenditure from €356 (41–668) to €428 (133–724).

Conclusions:

Low HGS at hospital admission is associated with increased hospitalization costs of between 16.6 and 20.0% after controlling for possible confounders, including undernutrition status. HGS is an inexpensive, noninvasive and easy-to-use method that has clinical potential to predict hospitalization costs.

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Acknowledgements

We thank Centro Hospitalar do Porto and all ward directors for facilitating the data collection. Rita S Guerra as a PhD student received a scholarship from FCT—Fundação para a Ciência e a Tecnologia under the project (SFRH/BD/61656/2009).

Author information

Authors and Affiliations

  1. Departamento de Bioquímica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal,

    R S Guerra

  2. UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal,

    R S Guerra, T F Amaral & M T Restivo

  3. Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal,

    R S Guerra, A S Sousa, F Pichel & I Fonseca

  4. Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal,

    T F Amaral & A S Sousa

  5. Serviço de Informação de Gestão, Centro Hospitalar do Porto, Porto, Portugal,

    S Ferreira

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  1. R S Guerra
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Correspondence to R S Guerra.

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Guerra, R., Amaral, T., Sousa, A. et al. Handgrip strength measurement as a predictor of hospitalization costs. Eur J Clin Nutr 69, 187–192 (2015). https://doi.org/10.1038/ejcn.2014.242

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