Handgrip strength and endurance as a predictor of postoperative morbidity in surgical patients: can it serve as a simple bedside test?

Postoperative morbidity is related to preoperative nutritional status. Current methods of assessing this are cumbersome, lack sufficient accuracy to completely separate all those at risk from others, and require a laboratory backup. This study was done to evaluate handgrip manometry, a simple bedside test as an indicator of preoperative nutritional status to predict risk of postoperative complications. Normal values for maximal grip strength and endurance times were established in 496 controls. Similar values were recorded in 100 patients undergoing elective surgery preoperatively. Postoperative variables studied included complication rate and hospital stay. The efficacy of four parameters, serum albumin, clinical nutritional score based on subjective global assessment, maximal grip strength (MGS), and grip endurance time, in predicting complications were studied. It was found that age and presence of co-morbidity increased risk of complications. Of the four predictive parameters studied, it was found that MGS is better than serum albumin. Clinical scoring was superior to MGS in predicting risk of complications. MGS is a simple bedside test, which can be easily performed. It can be used as a complimentary test to clinical scoring in identifying patients at risk of complications after surgery. Patients with abnormal MGS require urgent preoperative correction to reduce the risk of complications.