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      Hand grip strength in venous thromboembolism: risk of recurrence and mortality

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          Abstract

          Background

          There is limited information on the relationship between muscle strength and recurrence and mortality after incident venous thromboembolism (VTE).

          Objectives

          To investigate whether weak hand grip strength (HGS) was associated with risk of recurrence and mortality in patients with VTE recruited from the general population.

          Methods

          Participants from the Tromsø Study with a first-time VTE ( n = 545) were included, and all VTE recurrences and deaths among the participants were recorded in the period 1994 to 2020. Weak HGS was defined as lowest 25th percentile of the general population, and incidence rates for VTE recurrence and mortality according to weak vs normal (>25th percentile) HGS, with 95% CIs, were estimated.

          Results

          There were 90 recurrences and 350 deaths during a median of 3.7 years of follow-up. The fully adjusted hazard ratio (HR) for overall VTE recurrence for those with weak HGS vs those with normal HGS was 2.02 (95% CI, 1.23-3.30). The corresponding HRs for recurrence were 2.22 (95% CI, 1.18-4.17) in patients with a first deep vein thrombosis and 1.60 (95% CI, 0.72-3.57) in patients with a first pulmonary embolism. The cumulative 1-year survival was 74.9% and 77.8% in those with weak and normal HGS, respectively. For overall mortality after incident VTE, the fully adjusted HR for those with weak HGS was 1.34 (95% CI, 1.04-1.72).

          Conclusion

          Weak HGS was associated with an increased risk of recurrent VTE, and the association appeared to be particularly pronounced after incident deep vein thrombosis. There was a slightly lower survival probability among those with weak HGS than among those with normal HGS.

          Essentials

          • •

            Hand grip strength (HGS) is related to adverse health outcomes and mortality.

          • •

            We assessed the association of HGS with recurrent venous thromboembolism and mortality.

          • •

            Individuals with weak HGS had a higher risk of venous thromboembolism recurrence compared with those with normal HGS.

          • •

            Individuals with weak HGS had a slightly higher mortality risk than those with normal HGS.

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          Most cited references53

          • Record: found
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          Sarcopenia: revised European consensus on definition and diagnosis

          Alfonso Cruz-Jentoft, Gulistan Bahat, Jürgen Bauer … (2018)
          Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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            Incidence and mortality of venous thrombosis: a population-based study.

            I Naess, S C Christiansen, P. Romundstad … (2007)
            Estimates of the incidence of venous thrombosis (VT) vary, and data on mortality are limited. We estimated the incidence and mortality of a first VT event in a general population. From the residents of Nord-Trøndelag county in Norway aged 20 years and older (n = 94 194), we identified all cases with an objectively verified diagnosis of VT that occurred between 1995 and 2001. Patients and diagnosis characteristics were retrieved from medical records. Seven hundred and forty patients were identified with a first diagnosis of VT during 516,405 person-years of follow-up. The incidence rate for all first VT events was 1.43 per 1000 person-years [95% confidence interval (CI): 1.33-1.54], that for deep-vein thrombosis (DVT) was 0.93 per 1000 person-years (95% CI: 0.85-1.02), and that for pulmonary embolism (PE) was 0.50 per 1000 person-years (95% CI: 0.44-0.56). The incidence rates increased exponentially with age, and were slightly higher in women than in men. The 30-day case-fatality rate was higher in patients with PE than in those with DVT [9.7% vs. 4.6%, risk ratio 2.1 (95% CI: 1.2-3.7)]; it was also higher in patients with cancer than in patients without cancer [19.1% vs. 3.6%, risk ratio 3.8 (95% CI 1.6-9.2)]. The risk of dying was highest in the first months subsequent to the VT, after which it gradually approached the mortality rate in the general population. This study provides estimates of incidence and mortality of a first VT event in the general population.
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              The epidemiology of venous thromboembolism

              John Heit, Frederick A Spencer, Richard White (2016)
              Venous thromboembolism (VTE) is categorized by the U.S. Surgeon General as a major public health problem. VTE is relatively common and associated with reduced survival and substantial health-care costs, and recurs frequently. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and VTE risk factors, including increasing patient age and obesity, hospitalization for surgery or acute illness, nursing-home confinement, active cancer, trauma or fracture, immobility or leg paresis, superficial vein thrombosis, and, in women, pregnancy and puerperium, oral contraception, and hormone therapy. Although independent VTE risk factors and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be relatively constant, or even increasing.
              Article 0 comments Cited 313 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Oda G.R. Leknessund: @OdaLeknessund
                Sigrid K. Brækkan: @SBraekkan
                Journal
                Journal ID (nlm-ta): Res Pract Thromb Haemost
                Journal ID (iso-abbrev): Res Pract Thromb Haemost
                Title: Research and Practice in Thrombosis and Haemostasis
                Publisher: Elsevier
                ISSN (Electronic): 2475-0379
                Publication date PMC-release: 29 June 2023
                Publication date Collection: July 2023
                Publication date (Electronic): 29 June 2023
                Volume: 7
                Issue: 5
                Electronic Location Identifier: 102138
                Affiliations
                [1 ]Thrombosis Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
                [2 ]Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
                Author notes
                [∗ ] Correspondence Oda G. R. Leknessund, Thrombosis Research Group, Department of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway. oda.g.leknessund@ 123456uit.no @OdaLeknessund
                Article
                Publisher Item ID: S2475-0379(23)00188-7 Publisher ID: 102138
                DOI: 10.1016/j.rpth.2023.102138
                PMC ID: 10439395
                PubMed ID: 37601029
                SO-VID: 4047efab-b56c-4c0c-93ae-00bd9b148e58
                Copyright © © 2023 The Author(s)
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 18 January 2023
                Date revision received : 9 June 2023
                Date accepted : 21 June 2023
                Categories
                Subject: Original Article

                Keywords: hand strength,recurrence,risk factor,venous thromboembolism,venous thrombosis
                Data availability:
                Keywords: hand strength, recurrence, risk factor, venous thromboembolism, venous thrombosis

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