Association of grip indicators with post-discharge recovery in geriatric and hip fracture inpatients

OBJECTIVES: Hand grip measures offer potential indicators for recovery after hospitalization in older adults. We investigated prospective associations of the grip indicators maximal grip strength (GSmax), fatigue resistance (FR) and grip work (GW) with post-discharge functional limitations, health-related quality of life (HRQOL) and survival in older inpatients. METHODS: Grip indicators were evaluated at admission in general geriatric inpatients (GGI, n = 149) and geriatric hip fracture inpatients (HIP, n = 109). Questionnaires on functional limitations (10-40, lower is better) were collected for two weeks pre-admission, admission, three months follow-up, and six months follow-up. HRQOL (-4-10, higher is better) was assessed at admission, three months follow-up and six months follow-up. With individual growth modeling, we established the associations between grip indicators and the outcome trajectories. Three-month survival was analyzed using Cox proportional hazards models. RESULTS: In GGI, higher FR and GW were associated with better functional recovery from admission to three months follow-up (FR: B = -1.0 points per 10s increase, 95 %CI -1.9, -0.14; GW: B = -0.33 points per 100 kPa × s increase, 95 %CI -0.59, -0.07). HIP with higher grip indicators showed a better functional recovery towards three months follow-up (GSmax: B = -2.4 per 10 kPa increase, 95 %CI -3.9, -0.89; FR: B = -1.1, 95 %CI -2.4, 0.20; GW: B = -0.31, 95 %CI -0.61, -0.02). No or weak associations were found between grip indicators and HRQOL recovery. Hazard ratios pointed towards a better survival for better scores on grip indicators, but associations were not statistically significant. CONCLUSION: Higher FR and GW at admission were associated with better recovery post-discharge in geriatric inpatients. Future research should examine the added clinical value of grip indicators in addition to known patient characteristics.