An Observational Prospective Study To Evaluate The Correlation Of Handgrip Strength With RCRI and Lab Investigations For Preoperative Assessment Of Fraility In Patients Undergoing Lower Limb Orthopaedic Surgeries

Aging is a global phenomenon and the elderly adults carry an increasing burden of chronic illnesses which affect their overall health and well-being. Fraility is identified by decreased reserves in multiple organ systems. Fraility has been known to be associated with postoperative adverse events and Longer Hospital Length of Stay (LOS). Identifying frail patients has always been an important part of improving post operative outcome. Assessing the skeletal muscle reserves has been an integral part of predicting the nutritional status of the patient and also the post-operative outcome.Estimates of skeletal protein and plasma albumin concentrations is useful in detecting malnutrition. Hypoalbuminemia accurately reflects malnutrition and a low preoperative albumin concentration was associated with high post-operative complications. Researchers have defined appreciable protein depletion as existing when arm muscle circumference is below 85% of the standard, hand grip strength is below 85% of normal, or plasma albumin concentration below 35 g/l. Handgrip dynamometry is a sensitive screening test to detect preoperative malnutrition and predict postoperative complications. Hand grip strength (HGS) is used to diagnose both sarcopenia and frailty. Low grip strength is consistently associated with a greater likelihood of premature mortality, development of disability and an increased risk of complications. the gold standard of risk stratification in pre-operative settings include the use of the Revised Cardiac Risk Index (RCRI). Previous studies have concluded that a weaker Hand grip strength was significantly associated with lower levels of serum albumin, higher RCRI score, and a longer hospital LOS in patients undergoing major surgery.