Abstract
BACKGROUND: Cardiac surgery is a critical treatment option for patients with cardiovascular disease; however, it carries a significant risk of complications. The aim of this study was to investigate the association between changes in handgrip strength and postoperative complications in older adults undergoing cardiac surgery to establish handgrip strength as a practical tool for improving surgical outcomes. METHODS: This prospective cohort study included 105 patients aged 60 years or more who underwent cardiac surgery. We evaluated whether handgrip recovery (handgrip strength on postoperative day 5/preoperative handgrip strength) was superior to absolute handgrip strength in predicting 30-day postoperative complications. Logistic regression analysis was performed to determine the association between handgrip recovery and the incidence of postoperative complications. RESULTS: Among the 105 patients, 65 experienced 30-day postoperative complications. The area under the receiver operating characteristic curve for handgrip recovery as a predictor of complications was 0.765 (P < .001), with an optimal cutoff value of 86.67%. Patients with lower grip recovery showed a 10.56-fold higher risk of 30-day postoperative complications than those with normal recovery. When patients were compared using the cutoff value for handgrip recovery, those in the low recovery group exhibited significantly poorer outcomes, including a longer intensive care unit stay (4 vs 3 days, P = .007) and longer hospitalization (8 vs 7 days, P = .002). Logistic regression analysis demonstrated a statistically significant association between handgrip recovery and the incidence of postoperative complications. CONCLUSIONS: Low handgrip recovery is a superior predictor of postoperative complications, including longer intensive care unit and hospitalization durations, in older patients who undergo cardiac surgery under cardiopulmonary bypass.