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Research letter
Handgrip weakness and mortality risk in COPD: a multicentre analysis
  1. Chris Burtin1,
  2. Gerben ter Riet2,
  3. Milo A Puhan3,
  4. Benjamin Waschki4,
  5. Judith Garcia-Aymerich5,6,
  6. Victor Pinto-Plata7,8,
  7. Bartolome Celli7,
  8. Henrik Watz4,9,
  9. Martijn A Spruit1,10
  1. 1Faculty of Medicine and Life Sciences, Rehabilitation Research Centre, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
  2. 2Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  3. 3Department of Epidemiology, Biostatistics & Prevention Institute, University of Zurich, Zurich, Switzerland
  4. 4LungenClinic Grosshansdorf, Grosshansdorf, Germany
  5. 5Centre for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra (UPF), Barcelona, Spain
  6. 6CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  7. 7Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  8. 8Pulmonary and Critical Care Medicine Division, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA
  9. 9Pulmonary Research Institute, Airway Research Center North (ARCN), German Center for Lung Research, Grosshansdorf, Germany
  10. 10Department of Research & Education, CIRO+ Center of Expertise for Chronic Organ Failure, Horn, The Netherlands
  1. Correspondence to Dr Chris Burtin, Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek 3590, Belgium; chris.burtin{at}

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Handgrip strength is a simple measure of upper limb muscle function that is associated with mortality in the general population and in patients with COPD.1 ,2 Recently, normative values for handgrip strength have been proposed based on centile scores in >224 000 healthy adults between 39 and 73 years of age, adjusted for age, sex, height and measurement side.3 As an illustration, in a typical 65-year-old male patient 5th and 10th centile of right handgrip strength range 18–28 kg and 20–30 kg, respectively, depending on the patient's height. It is unclear whether the identification of handgrip weakness based on these centiles has prognostic value in addition to known prognostic parameters like FEV1, age, dyspnoea symptoms (combined in the validated ADO index4) and body mass index (BMI).

Therefore, we performed an a posteriori analysis of prospectively collected multicentre data in patients with stable COPD, followed for a median of 3.9 years.2 ,5–7

Handgrip strength was assessed using …

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