Cutoff points for handgrip strength in patients with liver cirrhosis: a multicenter study

Objectives: This study aimed to define handgrip strength (HGS) cutoff points to predict 1-year mortality in adult patients with liver cirrhosis. Methods: This is an analysis of cohort databases from four reference centers in Brazil. Inpatients or outpatients with cirrhosis and aged >= 18 years were included. The best cutoff values of HGS (highest value from three attempts with the non-dominant hand) for predicting 1-year mortality, stratified by sex and age, were established based on the sensitivity and specificity analyses. Adjusted Cox regression models were used to test the predictive value of low HGS. Results: The study included 724 patients with cirrhosis, with a median age of 57.0 years (IQR: 50.0-63.0), 66.4% (n = 481) male. Most patients had alcoholic cirrhosis (n = 281; 38.8%), 400 (55.3%) were classified as Child-Pugh B or C, and 134 (18.5%) patients died after 1-year. The HGS cutoffs were <= 33 kgf and <= 12 kgf for men and women aged <60 years, respectively, and <= 22 kgf and <= 10 kgf for older men and women, respectively (sensitivity: 70.9%; specificity: 61.2%). Low HGS was associated with a 2.5-fold increase in the risk of 1-year mortality. Conclusion: These cutoff points could be used to identify patients with a higher mortality risk.