Evaluating Hand Grip Strength Prior to Hematopoietic Stem Cell Transplantation as a Predictor of Patient Outcomes

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Abstract

Background and Purpose:

The primary purpose of this study was to determine the predictive capacity of hand grip strength on overall survival among patients undergoing hematopoietic stem cell transplantation (HCT).

Design:

Retrospective chart review.

Setting:

Hand grip strength was measured at the time of HCT in an inpatient setting in 2009.

Patients:

Forty-nine patients with various hematologic malignancies.

Intervention:

Hand grip strength was performed using the dominant hand. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) was administered during the same visit. Chart abstraction was performed 5 years postassessment to obtain mortality data, Karnofsky Performance Status (KPS) at HCT, graft type, gender, comorbidity index, and age at HCT.

Main Outcome Measure:

Survival

Results:

Median follow-up time was 5.62 years. In multivariable analyses, higher hand grip strength was associated with shorter length of stay, higher FACIT-F total score, and higher FACIT-F subscale score in female patients only. Higher hand grip strength was associated with an improved overall survival in all patients with and without adjustment for gender, graft type, and comorbidity index (unadjusted hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.74-0.99; P = .034; adjusted HR: 0.82; 95% CI: 0.69-0.98; P = .033).

Limitations:

Retrospective design did not allow for assessment of posttransplant complications.

Conclusion:

Higher hand grip strength was associated with a shorter length of stay, higher quality of life, and lower fatigue for female patients, and better overall survival among men and women. Larger prospective studies are needed to confirm this finding.

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