Hand Grip Strength and Prognosis in Hospitalized Cancer Patients (PRO-HAND)

Hospitalized Cancer Patients: Prognostic Value of Hand Grip Strength - A Prospective Cohort Study

This prospective cohort study aims to investigate the relationship between hand grip strength and prognosis in hospitalized cancer patients. Hand grip strength, a simple, rapid, and non-invasive measure of overall muscle function, is increasingly recognized as an indicator of frailty, nutritional status, and physical health. The study will evaluate whether lower hand grip strength is associated with higher short-term mortality (30-day all-cause mortality) and adverse clinical outcomes, including ICU admission, hospital readmission, and functional decline.

Study Overview

• Status: Completed
• Conditions: Cancer; Sarcopenia; Hospitalizations; Cachexia; Cancer; Sarcopenia
• Intervention / Treatment: Other: Hand Grip Strength Measurement

Detailed Description

Hand grip strength declines with age and is associated with frailty, sarcopenia, and cancer cachexia. It is a reliable prognostic marker in cancer patients. In this prospective cohort study, hospitalized patients with pathologically confirmed cancer will undergo hand grip strength measurement within the first 24 hours of admission using a calibrated hand dynamometer. Measurements will be performed on the dominant hand, with patients seated, following international standardized procedures. Three consecutive measurements will be obtained, and the average value will be recorded. Assessments will be conducted by oncology clinicians trained in the protocol. Patients will be followed for 30 days to evaluate primary and secondary endpoints, including all-cause mortality, functional decline, length of hospital stay, intensive care unit admission, readmission, and major complications.

• Study Type: Observational
• Enrollment (Actual): 130

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Yenimahalle
    • Ankara, Yenimahalle, Turkey (Türkiye), 06210
      • Etlik City Hospital, Medical Oncology Department

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of adult patients aged 18 years and older with pathologically confirmed cancer who are admitted to the Ankara Etlik City Hospital, Department of Medical Oncology. Eligible participants are hospitalized for more than 48 hours and undergo hand grip strength measurement within 24 hours of admission. Patients represent a heterogeneous group of solid tumor cases across different cancer types and stages, reflecting a real-world hospitalized oncology population.

Description

Inclusion Criteria:

• Adults aged 18 years and older
• Pathologically confirmed diagnosis of cancer
• Hospitalized with an expected hospital stay of more than 48 hours
• Ability to provide written informed consent

Exclusion Criteria:

• Diagnosis of anorexia nervosa
• Acute pancreatitis or acute liver failure at admission
• History of gastric bypass surgery
• Presence of chronic active infections
• History of solid organ transplantation
• Pregnant or breastfeeding women

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Hospitalized Cancer Patients; This cohort consists of adult patients (aged 18-80 years) with pathologically confirmed cancer who are admitted to the hospital for at least 48 hours. Hand grip strength is measured within the first 24 hours of admission using a standardized dynamometer protocol. Patients are followed prospectively for 30 days to evaluate primary and secondary outcomes including all-cause mortality, functional decline, hospital stay duration, readmission, and major complications.

Other: Hand Grip Strength Measurement; Hand grip strength will be measured within the first 24 hours of hospitalization using a calibrated hand dynamometer. Measurements will be performed on the dominant hand, with patients seated, following standardized international procedures. Three consecutive measurements will be obtained, and the average value will be recorded. The test is non-invasive, quick, and performed by oncology clinicians trained in the protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
30-day All-Cause Mortality	All-cause mortality within 30 days of hospital admission among cancer patients (Yes/No). Mortality status will be assessed through hospital records and follow-up. Hand grip strength values will be analyzed in relation to mortality risk.	30 days after hospital admission

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intensive Care Unit Admission	Number of patients requiring ICU admission within 30 days of hospital admission (Yes/No).	30 days after hospital admission
Hospital Readmission	All-cause hospital readmission within 30 days of discharge (Yes/No).	30 days after discharge
Functional Decline - ECOG Performance Status	Decline in functional status assessed by the Eastern Cooperative Oncology Group (ECOG) Performance Status (range 0-4; 0 = fully active, 1 = restricted in strenuous activity, 2 = ambulatory but unable to work, 3 = limited self-care, 4 = completely disabled; higher score = worse performance), comparing baseline and 30-day follow-up.	Baseline and 30 days after hospital admission
Length of Hospital Stay	Duration of initial hospitalization, measured in days from admission to discharge.	Through initial hospitalization, up to 30 days
Major Complications	Incidence of major complications including hospital-acquired infection, respiratory failure, cardiovascular events, acute renal failure, or gastrointestinal failure within 30 days (Yes/No).	30 days after hospital admission
Functional Decline - Patient-Generated Subjective Global Assessment (PG-SGA)	Decline in nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) Score (range 0-35; 0-1 = no intervention required, 2-3 = patient/family education, 4-8 = requires dietitian intervention, ≥9 = critical need for nutritional intervention and/or symptom management; higher score = worse nutritional status), comparing baseline and 30-day follow-up.	Baseline and 30 days after hospital admission

Collaborators and Investigators

• Sponsor: Ankara Etlik City Hospital
• Investigators: Principal Investigator: Galip Can Uyar, MD, Ankara Etlik City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2024
• Primary Completion (Actual): October 20, 2024
• Study Completion (Actual): March 25, 2025

Study Registration Dates

• First Submitted: August 23, 2025
• First Submitted That Met QC Criteria: September 3, 2025
• First Posted (Estimated): September 11, 2025

Study Record Updates

• Last Update Posted (Estimated): September 11, 2025
• Last Update Submitted That Met QC Criteria: September 3, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Prognosis; Mortality; Malnutrition; Cachexia; Hand Grip Strength; Functional Decline; Hospitalized Cancer Patients
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neuromuscular Manifestations; Nutrition Disorders; Pathological Conditions, Anatomical; Body Weight; Body Weight Changes; Muscular Atrophy; Atrophy; Weight Loss; Thinness; Pathological Conditions, Signs and Symptoms; Nutritional and Metabolic Diseases; Signs and Symptoms; Malnutrition; Neoplasms; Sarcopenia; Cachexia
• Other Study ID Numbers: AEŞH-BADEK-2024-1105 (Other Identifier: Ankara Etlik City Hospital Ethics Committee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No