Prediction of risk of falls based on handgrip strength in chronic liver disease patients living independently

• Published in: Hepatology research Vol. 49; no. 7; pp. 823 - 829
• Main Authors: Hiraoka, Atsushi, Tamura, Rumi, Oka, Misato, Izumoto, Hirofumi, Ueki, Hidetaro, Tsuruta, Miho, Yoshino, Takeaki, Ono, Atsushi, Aibiki, Toshihiko, Okudaira, Tomonari, Yamago, Hiroka, Suga, Yoshifumi, Iwasaki, Ryuichiro, Mori, Kenichiro, Miyata, Hideki, Tsubouchi, Eiji, Kishida, Masato, Ninomiya, Tomoyuki, Hirooka, Masashi, Abe, Masanori, Matsuura, Bunzo, Hiasa, Yoichi, Kino, Tsutae, Yamamoto, Kayo, Michitaka, Kojiro
• Format: Journal Article
• Language: English
• Published: Netherlands Wiley Subscription Services, Inc 01-07-2019
• Subjects: Activities of daily living; chronic liver disease; Cirrhosis; Cognitive ability; cognitive function; Dementia disorders; falling; Falls; Geriatrics; handgrip strength; Hepatitis; Liver cirrhosis; Liver diseases; Patients; Risk factors; sarcopenia
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/hepr.13322

Aim
Falling is known to be associated with cognitive function. We evaluated the relationship between muscle function and falls in patients with chronic liver disease (CLD).
Methods
We enrolled 100 sequential CLD patients without dementia who were admitted to our institution for scheduled treatment from July 2017 to May 2018 (age 71.0 ± 10.2 years; 76 men). All subjects were self‐reliant in regard to activities of daily living. On admission, handgrip strength was determined and falls within 1 month of admission were noted. For determining handgrip strength decline (HSD), previously reported values were used (men, <26 kg; women, <18 kg). The relationship between HSD and falls in CLD patients was evaluated in a retrospective manner.
Results
Thirty‐two patients had chronic hepatitis and 49 had liver cirrhosis (LC) Child–Pugh A, 17 had LC Child–Pugh B, and 2 had LC Child–Pugh C. Twelve (12.0%) had a history of falling, including 8 (26.7%) of 30 with and 4 (5.7%) of 70 without HSD (P = 0.006). The cut‐off value for age in relationship to falling was 69.0 years old (area under the receiver operating characteristic curve, 0.668; 95% confidence interval, 0.514–0.821). A fall during hospitalization was noted more often in patients with a history of falling than in those without (16.7% [2/12] vs. 2.3% [2/88], P = 0.018).
Conclusion
In CLD patients, the presence of HSD and older age might be independent risk factors for predicting a fall. Assessment of handgrip strength could be an effective clinical tool for easily assessing the risk of falling, especially in elderly CLD patients.