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  • Original Article
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Protein, malnutrition and wasting diseases

Handgrip strength cutoff values for undernutrition screening at hospital admission

European Journal of Clinical Nutrition volume 68, pages 1315–1321 (2014)Cite this article

Subjects

Abstract

Background/Objectives:

There is increasing evidence showing that handgrip strength (HGS) is an indicator of nutrition status and a promising undernutrition screening tool. However, HGS cutoff values for inpatient undernutrition screening remain to be studied. The present study aims to define gender- and age-specific HGS cutoff values for undernutrition screening of hospitalized patients at admission.

Subjects/Methods:

A cross-sectional study was conducted in a university hospital. Gender- and age-specific receiver operating characteristic curves were constructed to evaluate the performance of HGS for correctly screening undernourished patients on the basis of their classification by Patient-Generated Subjective Global Assessment. Sensitivity, specificity, areas under the curves (AUCs) and positive likelihood ratios (LRs) were calculated.

Results:

The study sample was composed of 712 participants between the ages of 18 and 91 years old, median (interquartile range) of 58 (22) years. For women, HGS cutoff values, sensitivities and specificities were as follows: 18–44 years, 20.2 kgf, 0.741 and 0.556; 45–64 years, 19.2 kgf, 0.795 and 0.522. For men, these values were as follows: 18–44 years, 41.7 kgf, 0.923 and 0.520; 45–64 years, 37.9 kgf, 0.817 and 0.402; ⩾65 years, 30.2 kgf, 0.736 and 0.567. The AUCs varied between 0.642 and 0.778 and LRs from 1.37 to 1.92.

Conclusions:

This study provides HGS cutoff values for men aged 18–91 years and for women aged 18–64 years.

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Acknowledgements

We thank Centro Hospitalar do Porto and all ward directors for facilitating the data collection. RSG as a Ph.D. student is receiving a scholarship from FCT – Fundação para a Ciência e a Tecnologia under the project (SFRH/BD/61656/2009).

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Authors and Affiliations

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

    R S Guerra

  2. Unidade de Integração de Sistemas e Processos Automatizados, Instituto de Engenharia Mecânica (UISPA-IDMEC), Faculdade de Engenharia da Universidade do Porto, Porto, Portugal,

    R S Guerra, M T Restivo & T F Amaral

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

    R S Guerra, I Fonseca & F Pichel

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

    T F Amaral

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Correspondence to R S Guerra.

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Guerra, R., Fonseca, I., Pichel, F. et al. Handgrip strength cutoff values for undernutrition screening at hospital admission. Eur J Clin Nutr 68, 1315–1321 (2014). https://doi.org/10.1038/ejcn.2014.226

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