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Weak grip strength, fragility, risk factors linked in vascular disease
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Among patients with vascular disease undergoing procedures to treat abdominal aortic aneurysm, carotid stenosis or peripheral artery disease, weak grip strength was associated with fragility, which was in turn associated with elevated CV risk factors and comorbidities, researchers reported.
“Grip strength may have specific applicability for frailty assessment in patients with symptomatic PAD, including those with previous amputation, particularly if disease-related walking impairment confounds interpretation of waking-based measures,” Matthew A. Corriere, MD, MS, from the department of vascular and endovascular surgery at Wake Forest School of Medicine in Winston-Salem, North Carolina, said in a press release. “Although frailty may not be a modifiable risk factor, improved screening may facilitate individualized treatment selection, counseling and resource expectations.”
Corriere and colleagues measured dominant hand grip strength in 311 patients with vascular disease making ambulatory clinic visits to treat AAA, carotid stenosis or PAD. Patients were stratified by whether the grip strength test qualified them as frail. Outcomes of interest included Charlson Comorbidity Index, Revised Cardiac Risk Index and sarcopenia.
Among the cohort, 27.7% were classified as frail.
In a multivariable model, frailty was associated with elevated Charlson Comorbidity Index (OR = 1.86; 95% CI, 1.34-2.57), according to the researchers.
Corriere and colleagues also found that those with frailty had more Revised Cardiac Risk Index components than those without it (1.8 vs. 1.5; OR = 1.75; 95% CI, 1.16-2.64).
Total psoas area, an indicator of sarcopenia, was lower among patients with frailty (P = .01), and each 10-cm2 increase in psoas area was associated with a 5.7-kg increase in grip strength after adjustment for age and sex (P < .0001), the researchers wrote.
Adjusted least-squares mean psoas diameter estimates were lower in patients with PAD compared with patients with AAA (P = .053) or patients with carotid stenosis (P = .057).
“Our group plans to implement routine grip strength measurement during clinic intake for new patients as a larger-scale quality improvement initiative, with plans to re-evaluate approaches to perioperative testing, pre-habilitation and discharge planning,” Corriere said in the release. – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
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