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Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients.
BMC Geriatr. 2016 08 19; 16(1):153.BG

Abstract

BACKGROUND

Anaemia is a common problem in hospitalized older patients and is recognized as a risk factor for a significant number of adverse outcomes. Data of the effect of anaemia on functional status during hospitalization and mortality after discharge are limited. Aim of the study is to examine whether there is an association between anaemia, hand grip strength, gait speed and basic activities of daily living (ADL) during hospitalization and mortality 1 year after discharge in geriatric patients.

METHODS

In a prospective study, data on age, sex, body mass index, Mini-Mental State Examination (MMSE), main clinical diagnosis, number of comorbidities, hand grip strength, gait speed, ADL, haemoglobin, C-reactive protein and estimated Glomerular filtration ratio (eGFR) were recorded in 220 older patients, admitted to the acute geriatric ward of a university hospital. Anaemia was defined as a haemoglobin level <13 g/dL for men and <12 g/dL for women and was further specified into severe (haemoglobin level <10 g/dL for both men and women) and moderate anaemia (haemoglobin between 10 and 12 g/dL for women and 10 and 13 g/dL for men). Gait speed (in meters per second) was calculated after a 4.5 m walk and hand grip strength (in kilogram) was assessed with a hydraulic hand dynamometer. Functionality was assessed in the six basic activities of daily living. Information about the vital status was obtained 1 year after discharge with a telephone call. Analysis of covariance (ANCOVA) was used to examine the effect of the anaemia status on the walking speed, hand grip strength and premorbid ADL index and logistic regression analysis was used to examine whether anaemia could be identified as risk factors for mortality 12 months after discharge.

RESULTS

Overall, 106 (48 %) patients had anaemia. Hand-grip strength, gait speed and ADL score were not significantly different between anaemic and non-anaemic hospitalized geriatric patients. After adjustment for age, sex, body mass index, eGFR, MMSE, number of comorbidities and main clinical diagnosis, the means for hand-grip strength were 17.3, 19.9 and 19.1 kg (p = 0.38); for gait speed 0.57, 0.52 and 0.47 m/s (p = 0.28); and for the ADL score 3.50, 3.05 and 3.30 (p = 0.75) in patients with severe, moderate and without anaemia, respectively. In the unadjusted model, the odds ratio for mortality 1 year after discharge was 2.72 (95 % CI 1.20-6.14) and 4.70 (95 % CI 1.91-11.77) for moderate and severe anaemia, respectively, with no anaemia as the reference group. After adjustment for several confounders, a haemoglobin level less than 10 g/dl (OR 3.87; 95 % CI 1.25-11.99) remained significantly associated with an increased mortality over that 1 year period.

CONCLUSION

Our results do not support that anaemia on admission is associated with a decline in physical performance (hand grip strength and gait speed) and functionality (ADL) during hospitalization in older patients. However, severe anaemia is a significant risk factor for an increased mortality over a 1 year period after discharge.

Authors+Show Affiliations

Department of Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium. etienne.joosten@uzleuven.be.Department of Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.Department of Internal Medicine, Division of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27543049

Citation

Joosten, Etienne, et al. "Effect of Anaemia On Hand Grip Strength, Walking Speed, Functionality and 1 Year Mortality in Older Hospitalized Patients." BMC Geriatrics, vol. 16, no. 1, 2016, p. 153.
Joosten E, Detroyer E, Milisen K. Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients. BMC Geriatr. 2016;16(1):153.
Joosten, E., Detroyer, E., & Milisen, K. (2016). Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients. BMC Geriatrics, 16(1), 153. https://doi.org/10.1186/s12877-016-0326-y
Joosten E, Detroyer E, Milisen K. Effect of Anaemia On Hand Grip Strength, Walking Speed, Functionality and 1 Year Mortality in Older Hospitalized Patients. BMC Geriatr. 2016 08 19;16(1):153. PubMed PMID: 27543049.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients. AU - Joosten,Etienne, AU - Detroyer,Elke, AU - Milisen,Koen, Y1 - 2016/08/19/ PY - 2016/03/03/received PY - 2016/08/13/accepted PY - 2016/8/21/entrez PY - 2016/8/21/pubmed PY - 2017/6/24/medline KW - Activities of daily living KW - Anaemia KW - Gait speed KW - Hand grip strength KW - Hospitalized older patients SP - 153 EP - 153 JF - BMC geriatrics JO - BMC Geriatr VL - 16 IS - 1 N2 - BACKGROUND: Anaemia is a common problem in hospitalized older patients and is recognized as a risk factor for a significant number of adverse outcomes. Data of the effect of anaemia on functional status during hospitalization and mortality after discharge are limited. Aim of the study is to examine whether there is an association between anaemia, hand grip strength, gait speed and basic activities of daily living (ADL) during hospitalization and mortality 1 year after discharge in geriatric patients. METHODS: In a prospective study, data on age, sex, body mass index, Mini-Mental State Examination (MMSE), main clinical diagnosis, number of comorbidities, hand grip strength, gait speed, ADL, haemoglobin, C-reactive protein and estimated Glomerular filtration ratio (eGFR) were recorded in 220 older patients, admitted to the acute geriatric ward of a university hospital. Anaemia was defined as a haemoglobin level <13 g/dL for men and <12 g/dL for women and was further specified into severe (haemoglobin level <10 g/dL for both men and women) and moderate anaemia (haemoglobin between 10 and 12 g/dL for women and 10 and 13 g/dL for men). Gait speed (in meters per second) was calculated after a 4.5 m walk and hand grip strength (in kilogram) was assessed with a hydraulic hand dynamometer. Functionality was assessed in the six basic activities of daily living. Information about the vital status was obtained 1 year after discharge with a telephone call. Analysis of covariance (ANCOVA) was used to examine the effect of the anaemia status on the walking speed, hand grip strength and premorbid ADL index and logistic regression analysis was used to examine whether anaemia could be identified as risk factors for mortality 12 months after discharge. RESULTS: Overall, 106 (48 %) patients had anaemia. Hand-grip strength, gait speed and ADL score were not significantly different between anaemic and non-anaemic hospitalized geriatric patients. After adjustment for age, sex, body mass index, eGFR, MMSE, number of comorbidities and main clinical diagnosis, the means for hand-grip strength were 17.3, 19.9 and 19.1 kg (p = 0.38); for gait speed 0.57, 0.52 and 0.47 m/s (p = 0.28); and for the ADL score 3.50, 3.05 and 3.30 (p = 0.75) in patients with severe, moderate and without anaemia, respectively. In the unadjusted model, the odds ratio for mortality 1 year after discharge was 2.72 (95 % CI 1.20-6.14) and 4.70 (95 % CI 1.91-11.77) for moderate and severe anaemia, respectively, with no anaemia as the reference group. After adjustment for several confounders, a haemoglobin level less than 10 g/dl (OR 3.87; 95 % CI 1.25-11.99) remained significantly associated with an increased mortality over that 1 year period. CONCLUSION: Our results do not support that anaemia on admission is associated with a decline in physical performance (hand grip strength and gait speed) and functionality (ADL) during hospitalization in older patients. However, severe anaemia is a significant risk factor for an increased mortality over a 1 year period after discharge. SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/27543049/Effect_of_anaemia_on_hand_grip_strength_walking_speed_functionality_and_1_year_mortality_in_older_hospitalized_patients_ L2 - https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-016-0326-y DB - PRIME DP - Unbound Medicine ER -