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The study involved 82 consecutive acute admissions of female patients to a geriatric ward. A wide range of medical diagnoses was represented. The patients were assessed in relation to anthropometric measurements (grip strength, mid-arm circumference, triceps skin-fold, and arm muscle circumference), mental test score and serum albumin. The prognostic significance of these variables was considered with regard to mortality. Those who died had significantly lower grip strength (P less than 0.01), arm muscle circumference (P less than 0.05), serum albumin (P less than 0.01) and mental test score (P less than 0.01). A maximum grip strength of greater than or equal to 5 kg was the most sensitive and specific cut-off point to separate survival from death (true positive ratio 0.81, true negative ratio 0.92). Mental test score was positively correlated with grip strength and serum albumin. Grip strength was also measured in 35 healthy female controls of the same age group, and was found to be significantly greater than in the patient group (P less than 0.01). It appears that reduced grip strength, malnutrition and mental impairment are associated with increased risk of mortality in acute illness. Likely mechanisms are discussed.
Peter Phillips (Wed,) studied this question.