Hand Grip Strength and nutritional status in hospitalized oncological patients

ABSTRACT Objective To evaluate the nutritional status and functional capacity of hospitalized adult patients. Methods Cross-sectional study of adult oncology patients at Hospital de Clínicas de Porto Alegre. Patients were evaluated according to Solid Tumors and Hematologic Tumors. The nutritional status was obtained using Patient Generated Subjective Global Assessment, and the functional capacity was evaluated by Handgrip Strength using a Jamar® dynamometer – and the Performance Index of the Eastern Cooperative Oncology Group. Results This study evaluated 76 patients (56±17 years old, 35.5% female), 63.2% with Solid Tumors and 36.8% with Hematologic Tumors. According to the Patient Generated Subjective Global Assessment, 53.9% of the patients were moderately and severely malnourished and demonstrated functional capacity, according to the Handgrip Strength and Performance Index of the Eastern Cooperative Oncology Group, of 47.9% and 32.2%, respectively. The functional capacity instruments showed a moderate agreement (Kappa=0.427, p<0.001) and positive correlation (r=0.136, p=0.028). Severely malnourished patients had a lower Handgrip Strength when compared to well nourished (24.0±10.4 vs. 34.2±16.6kg, p=0.015). The results were confirmed among moderately and severely malnourished patients, who were rated at the 40 percentile, considered low functional capacity. Conclusion In this study, hospitalized oncological patients presented poor nutritional status and low functional capacity. The Patient Generated Subjective Global Assessment identifies the nutritional specification earlier. In addition, Handgrip Strength dynamometry can be a useful tool to evaluate the low functional capacity and nutritional status. It can be included in cancer patient’s evaluation, along with other nutritional assessment tools.

## 摘要
### 研究目的
评估住院成年肿瘤患者的营养状况与躯体功能状态。
### 研究方法
本研究针对阿雷格里港临床医院的成年肿瘤患者开展横断面研究。按照实体瘤与血液系统肿瘤对患者进行分组评估。营养状况采用患者主观整体营养评估（"Patient Generated Subjective Global Assessment"，PG-SGA）进行评定；躯体功能状态则通过Jamar®握力计检测握力，以及东部肿瘤协作组体能状态评分（"Eastern Cooperative Oncology Group Performance Index"，ECOG-PS）进行评估。
### 研究结果
本研究共纳入76例患者，年龄为56±17岁，女性占比35.5%；其中63.2%为实体瘤患者，36.8%为血液系统肿瘤患者。依据患者主观整体营养评估结果，53.9%的患者存在中重度营养不良；通过握力测试及东部肿瘤协作组体能状态评分评估，分别有47.9%、32.2%的患者存在躯体功能低下。两种躯体功能评估工具间存在中等程度的一致性（Kappa=0.427，P<0.001）及正相关关系（r=0.136，P=0.028）。重度营养不良患者的握力显著低于营养良好者（24.0±10.4 vs. 34.2±16.6kg，P=0.015）。中重度营养不良患者的体能状态评分处于40百分位，被判定为躯体功能低下，该结果验证了前述结论。
### 研究结论
本研究显示，住院肿瘤患者普遍存在营养状况不佳及躯体功能低下的问题。患者主观整体营养评估可更早识别营养不良状况。此外，握力计检测可作为评估躯体功能低下及营养状况的有效工具，可与其他营养评估工具一同纳入肿瘤患者的常规评估流程。