Grip strength is associated with postoperative adverse events in patients undergoing vascular surgery procedures.

Introduction: Frail patients with vascular disease have a high prevalence of adverse events, increase length of stay, and non-home discharge following surgical intervention. Because walking impairment is also common among these patients, use of walking-based measures (such as gait speed and metabolic equivalents) for perioperative risk assessment is potentially invalid and may lead to incorrect classification. We hypothesized that grip strength (GS) could be used to identify vascular patients with increased adverse events, length of stay, and non-home discharge following surgical intervention.

Methods: Dominant hand GS were measured during ambulatory clinic visits and in-patient wards among patients with vascular disease (including abdominal aortic aneurysm (AAA), carotid, and peripheral artery disease (PAD)). Patients undergoing open surgery within 90 days following grip measurement were included in this analysis. Associations between GS, postoperative adverse events and non-home discharge were evaluated using logistic regression models. Length of stay (LOS) was evaluated using cox proportional hazard regression models.

Results: GS was measured in 321 participants; 84 patients had undergone surgery following grip measurement (60 open vs 24 endovascular patients). Lower extremity bypass (18) and AAA (17) were the most common open procedures. In logistic models, weak grip strength was associated with occurrence of postoperative adverse event (OR 3.89, 95% CI 1.23-12.29; p=.021) and non-home discharge (OR 2.6, 95% CI 0.71-9.31; p=.150) following surgery. Median LOS was 4.5 days. Weak grip strength was associated with time to discharge (HR 1.68, 95% CI 0.94-3.02; p=.080) although not significant.

Conclusion: Weak grip strength is associated with postoperative adverse events among patients undergoing open vascular surgery. GS has potential utility as simple preoperative screening tool that can be performed easily in clinic, does not require imaging, and overcomes limitations related to walking impairment among patients with vascular disease.