Objective: This study aimed to assess handgrip strength (HGS) in patients with acute variceal bleeding (AVB) following endoscopic therapy, compare it with compensated cirrhotic patients, and investigate its association with clinical outcomes, including rebleeding and short-term mortality.
Materials and
Methods: In this single-center, prospective observational study, 34 AVB patients and 21 compensated cirrhotic were enrolled between May 2025-September 2025. Exclusion criteria included hepatocellular carcinoma, hepatic encephalopathy, malignancies, major organ failure, cerebrovascular disease, or neuromuscular disorders. HGS was measured using a digital dynamometer at discharge for AVB patients and during outpatient visits for controls. Baseline demographics, laboratory data, Child–Turcotte–Pugh (CTP) and model for end-stage liver disease (MELD-Na) scores, and 6-week outcomes were recorded. Statistical analyses compared HGS and clinical parameters between groups and evaluated correlations.

Results: HGS was significantly lower in the AVB group compared with compensated cirrhotic (p=0.0004). Within 6 weeks, nine patients experienced rebleeding, and seven patients died. Those with adverse outcomes demonstrated significantly reduced HGS, lower albumin, hemoglobin, and blood pressure, and higher MELD-Na and CTP scores. HGS negatively correlated with prognostic scores, hospital stay, international normalized ratio, and bilirubin, while positively correlating with albumin.

Conclusion: HGS is markedly reduced in patients with AVB and is associated with rebleeding, short-term mortality, and prolonged hospitalization. As a simple bedside measure of sarcopenia and nutritional status, HGS may serve as a valuable prognostic marker. Early identification of low HGS can guide nutritional and rehabilitative interventions to potentially improve outcomes in this high-risk patient population.