Impact of Hand Grip Strength on Length of Hospital Stay After Cardiac Surgery Among Elderly Patients

Study Overview
=================
Brief Summary
-----------------
Hand grip strength has been shown to be a predictor of adverse cardiovascular outcomes in the elderly population. This study aims to investigate whether measurement of hand grip strength could be used as a predictor of prolonged hospital stay after cardiac surgery in elderly patients.

Official Title
-----------------
Usefulness of Hand Grip Strength as a Predictor of Prolonged Hospital Stay in Elderly Patients Undergoing Cardiac Surgery

Conditions
-----------------
Frailty, Sarcopenia

Intervention / Treatment
-----------------
* Diagnostic Test: Hand grip strength measurement


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age ≥70 years Undergoing isolated coronary artery bypass grafting or isolated valve surgery or combined coronary and valve procedures Being oriented and cooperative enough to understand and comply with the instruction of gripping the hand dynamometer Exclusion Criteria: Age <70 years Emergent status Hemodynamic instability Inability to cooperate due to neurocognitive disorder Loss of upper extremity motor function of any degree (such as due to previous stroke) History of upper extremity amputation of any level

Ages Eligible for Study
-----------------
Minimum Age: 70 Years

Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Strong grippers<br> | Diagnostic Test: Hand grip strength measurement<br>* Preoperative hand grip strength will be measured in kilograms using a digital hand dynamometer (Baseline Smedley Digital Hand Dynamometer, Model 12-0286, Baseline Evaluation Instruments, China). Participants will be instructed to grip the hand dynamometer for 5 seconds with their dominant hand 3 times. They will be allowed to rest for 20 second between each grip. The highest measurement of 3 attempts will be recorded. Participants will be categorized as strong grippers or weak grippers according to Fried criteria as previously defined by Linda P. Fried and colleagues. A weak grip will be defined as follows: For men: BMI ≤24: hand grip strength ≤29 kg; BMI =24.1 to 28: hand grip strength ≤30 kg; BMI >28: hand grip strength ≤32 kg For women: BMI ≤23: hand grip strength ≤17 kg; BMI =23.1 to 26: hand grip strength ≤17.3 kg; BMI =26.1 to 29: hand grip strength ≤18 kg; BMI >29: hand grip strength ≤21 kg<br>|
| Weak grippers<br> | Diagnostic Test: Hand grip strength measurement<br>* Preoperative hand grip strength will be measured in kilograms using a digital hand dynamometer (Baseline Smedley Digital Hand Dynamometer, Model 12-0286, Baseline Evaluation Instruments, China). Participants will be instructed to grip the hand dynamometer for 5 seconds with their dominant hand 3 times. They will be allowed to rest for 20 second between each grip. The highest measurement of 3 attempts will be recorded. Participants will be categorized as strong grippers or weak grippers according to Fried criteria as previously defined by Linda P. Fried and colleagues. A weak grip will be defined as follows: For men: BMI ≤24: hand grip strength ≤29 kg; BMI =24.1 to 28: hand grip strength ≤30 kg; BMI >28: hand grip strength ≤32 kg For women: BMI ≤23: hand grip strength ≤17 kg; BMI =23.1 to 26: hand grip strength ≤17.3 kg; BMI =26.1 to 29: hand grip strength ≤18 kg; BMI >29: hand grip strength ≤21 kg<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prolonged hospital stay | Prolonged hospital stay is defined as postoperative hospital stay for ≥14 days. | 14 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prolonged intensive care unit stay | Prolonged intensive care unit stay is defined as postoperative intensive care unit stay for >48 hours. This includes sum of all time spent in intensive care unit including unplanned returns. | 48 hours | 
| Prolonged mechanical ventilation | Prolonged mechanical ventilation is defined as mechanical ventilation of >12 hours. This includes re-intubations and non-invasive mechanical ventilation. | 12 hours |