Association between Handgrip Strength and the Six-Minute Walk Test with Length of ICU and Hospital Stay in Patients Undergoing Surgery for Intra-Abdominal Cancers

R, Taghipour; Abedi Yekta, A. H; Rabbani, Amirhassan; Sohrabi, M

doi:10.22034/ijs.2026.742853

Association between Handgrip Strength and the Six-Minute Walk Test with Length of ICU and Hospital Stay in Patients Undergoing Surgery for Intra-Abdominal Cancers

Authors

Taghipour R ¹

A. H Abedi Yekta ²

amirhassan rabbani ³

M Sohrabi ⁴

¹ Assistant Professor, Department of Sports Medicine, Ayatollah Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

² Associate Professor, Department of Sports Medicine, Ayatollah Taleghani Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

³ Department of Transplant and Hepatobiliary Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁴ Professor, Department of Social Medicine, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

10.22034/ijs.2026.742853

Abstract

Background and Objective: Intra-abdominal cancers are among the most common malignancies in Iran, and surgery remains the primary treatment for patients with advanced disease. Simple functional measures, such as handgrip strength (HGS) and six-minute walk distance (6MWD), may help predict postoperative outcomes. This study aimed to investigate the association between HGS and 6MWD with the length of intensive care unit (ICU) and hospital stays in patients undergoing surgery for
intra-abdominal cancers.
Materials and Methods: This prospective cohort study was conducted between 2021 and 2022 at Ayatollah Taleghani Hospital in Tehran, Iran. A total of 260 patients with intra-abdominal malignancies who underwent surgery were enrolled. The sample size was initially calculated based on mortality; however, it was also adequate for analyzing length-of-stay outcomes. After obtaining written informed consent and confirming eligibility, HGS and the distance covered during the 6-minute walk test (6MWD) were measured preoperatively. Data were analyzed using SPSS version 25. Independent-samples t-tests, Mann–Whitney U tests, and linear regression analyses were employed for statistical analysis.
Results: Among men, patients with an HGS greater than 24.9 kg had significantly shorter ICU stays compared to those with lower HGS (effect size: Cohen's d = 3.2, P < 0.001). A similar association was observed among women using a cutoff value of 19.9 kg (P < 0.001, Cohen's d = 2.9). Higher HGS was also significantly associated with shorter hospital stays, with cutoff values of 26.9 kg for men and 19.75 kg for women (both P < 0.001). Similarly, patients with better functional capacity, defined as a 6MWD exceeding 414 m in men and 402 m in women, had significantly shorter ICU stays (P < 0.001). Only four patients required mechanical ventilation; therefore, the analysis of its association with extubation lacked sufficient statistical power and was considered exploratory.
Conclusions: HGS and 6MWD were significantly associated with the length of ICU and hospital stays following surgery for intra-abdominal cancers. These findings suggest that HGS and 6MWD may serve as simple, noninvasive, and readily available tools for predicting postoperative outcomes and identifying patients at increased risk of prolonged hospitalization. The main limitations of this study include the small number of mechanically ventilated patients, the single-center design, the lack of external validation of the proposed cutoff values, and the absence of survival analysis.

Keywords

Walk Test

Abdominal Neoplasms

Intensive Care Units

Length of Stay

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