Grip Strength and Surgery: The New Essential Biomarker

Imagine if a simple handshake could reveal a patient’s readiness for surgery and predict their recovery. Hand grip weakness, or signs of losing hand strength, can be a valuable health indicator. In this article, we explore several grip strength insights related to surgery.

Grip strength has rapidly emerged as a critical biomarker in surgical care, offering a reliable, non-invasive tool for assessing a patient’s overall health status.

Its value extends across both major and minor surgeries for a number of health conditions, making it an indispensable tool in diverse surgical settings, including ambulatory surgery centers (ASCs). 

“Grip strength is a key indicator of health; it’s a proxy for your overall strength and physical function.” 
Peter Attia MD

Weak grip strength is an important health indicator. Research shows that lower grip strength is linked to increased risks of complications, longer recovery times, and hospital readmissions, while stronger grip strength is associated with smoother recoveries. 

Incorporating grip strength into routine preoperative assessments provides a simple and effective tool for predicting:

  • Pre-surgical risk: identifying those who are better equipped to handle surgical stress and those who may require additional support before their procedure. 
  • Post-surgery readiness for discharge: providing a clear indication of a patient’s recovery progress and helping to determine discharge timing, which is particularly important in settings where rapid yet safe turnover is required.

This document outlines how integrating grip strength measurements into surgical assessments can optimize patient management, enhance risk stratification, and reduce avoidable healthcare costs. 

GRIP STRENGTH & SURGERY 

Grip Strength and Surgery: Selective Highlights 

Grip Strength and Pre-Surgical Risk 

  • In patients undergoing hip arthroplasty, patients with poor grip strength are over 7 times more likely to experience a major complication within 90 days of surgery, including heart attack, sepsis, stroke, prosthetic joint infection and death [Long et al 2021]. 
  • A minimum grip strength of 31.2 lbs* for men and 17.5 lbs* for women is the most important factor in predicting ambulation within 3 days after hip fracture surgery. Patients demonstrating this early ambulation have fewer complications such as pneumonia, pressure ulcers, delirium, urinary tract infections, and blood clots [Chang et al 2021]. 
  • In patients undergoing surgery for vascular disease, every 19.3 lbs* increase in grip strength decreases the risk of 30-day perioperative adverse events by 59% (including surgical site infection, >2 day stay in ICU, hospital readmission) [Reeve et al 2021]. 

Grip Strength and Post-Surgical Readiness for Discharge

  • In patients undergoing surgery for vascular disease, every 19.3 lbs* increase in grip strength decreases the risk of non-home discharge (needing skilled nursing or rehab facilities) by 66% (HR 0.34). Patients undergoing open surgeries (rather than endovascular surgery) have a >10-fold increased risk of non-home discharge (HR 10.36) [Reeve et al 2021]. 
  • Preoperative grip strength (OR=1.13) is an independent predictive factor of early ambulation (≥ 30 m within 24 hrs), as well as being a risk predictor for preoperative nutritional risk, in patients undergoing laparoscopic surgery for Gastrointestinal Tumours [Zhou et al 2023]. 

*Note that all cut-offs points have been converted into GripAble-equivalent measurements for consistency. 

& SURGERY 

Grip Strength and Surgery in Practice 

Clinical Application 

Measure grip strength during routine preoperative assessments to make informed decisions about surgical risk and readiness for discharge.

Pay attention when recorded grip strength is below normal cut-off points. Noticing these signs of weak hand grip strength enables the early identification of high-risk patients, improving both short term and long-term post-operative outcomes. 

Patient Empowerment 

Provide patients with access to their grip strength scores, helping them to understand their physical readiness for elective surgery and whether they could benefit from prehabilitation. 

Ongoing access to grip strength scores empowers patients to actively participate in their recovery and rehabilitation process, which is critical to improving post-discharge outcomes and minimizing complications. 

Practical Considerations 

Ease of use when testing grip strength: Measuring grip strength with a hand dynamometer is simple, non-invasive and cost-effective, making it easy to integrate into pre-surgical assessments.

This is especially the case in settings such as ASCs where time and resources may be limited. 

Remote monitoring of grip strength before and after surgery: Consider ongoing measurement of grip strength after surgery and post discharge – monitor trends in grip strength to track patient progress, or spot declines or loss of grip strength which may be indicative of difficulties within the expected recovery trajectory.

This could be especially useful in the elderly or those with pre-existing conditions such as cancer or frailty. A decline from pre-op baseline to post-surgical measurements showing increased weakness in hand grip strength could warrant clinical intervention.

Impact: Grip Strength and Surgery 

Patients: Grip strength weakness can provide an early identification of potential complications, guiding targeted preoperative care such as nutritional support or physical therapy to improve outcomes. Patients with higher grip strength recover faster, with shorter hospital stays and smoother returns to daily life compared to those showing signs of lower hand grip strength.

Clinicians: Grip strength offers a quick, objective measure of surgical readiness, ensuring safe and timely discharge, and supporting tailored care plans and assessment of recovery progress. 

For the Healthcare System (Including ASCs): Grip strength testing is a cost-effective tool that enhances risk stratification, optimizes resource allocation, reduces readmissions, and ensures safe, efficient patient flow in ASCs.

Able Assess 

The Only Grip Strength Platform Equipped for Data-Driven Healthcare. 

Designed to unlock the full potential of grip strength as a vital health biomarker, Able Assess meets the demand for high-quality, data-driven healthcare. 

Able Assess is a groundbreaking, digitally enabled platform for grip strength measurement. 

It combines our advanced digital dynamometer sensor technology with a comprehensive integrative platform and the most up-to-date normative dataset on the market to empower clinicians with actionable information that traditional tools simply can’t offer.

 

What’s Next?

For further reading, dive into our extensive collection of studies on using a hand dynamometer, grip strength and more here including:

Contribute: Partner with us in research or patient case studies to advance the knowledge of grip strength as a biomarker.

Understand: Get the essentials on hand dynamometry and how to integrate grip strength into your practice with our comprehensive guide

Get in touch: 

Website: www.able-care.co Email: hello@able-care.co