Initial handgrip strength as a predictive factor for amputation risk in diabetic foot patients

Abstract

BackgroundWe aimed to analyze the prognostic significance of handgrip strength as predictor of lower extremity amputation at 1year follow up in patients with type 2 diabetes.MethodsWe evaluated 526 patients with type 2 diabetes between August 2020, and, June 2022. We collected from the electronic medical records demographic variables, laboratory data and history of amputation. The handgrip strength was assessed using a handheld Smedley digital dynamometer following the NHANES Muscle Strenght/Grip Test Procedure. Low handgrip strength was defined for women as less than 16kg and for men less than 27kg. Outcome variable was major or minor lower extremity amputation.ResultsA total of 205 patients with complete data entered the study. Patients mean age was 59 years old, 37% were women and the mean diabetes disease duration was 14 years. Seventy-seven (37%) patients suffered from lower extremity mputations (26 major and 51 minor amputations). After controlling for age, gender, presence of peripheral artery disease, body mass index and white cell counts as confounder variables, patients with low handgrip had an increased risk for amputations (Odds Ratio 2.17; 95% confidence Interval: 1.09–4.32; <0.001).ConclusionLow handgrip stregth is an independent prognostic marker for lower limb amputation at one year in patients with diabetes.