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Consensus-defined sarcopenia predicts adverse outcomes after elective abdominal surgery: meta-analysis.
Brittany Park1, Sameer Bhat1, Weisi Xia1
1Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
BJS Open
|August 5, 2023
Summary
Sarcopenia, defined by low muscle strength and mass, significantly increases risks for complications and mortality after abdominal surgery. Preoperative assessment and interventions targeting sarcopenia may improve patient outcomes.
Area of Science:
- Gerontology
- Surgical Outcomes
- Muscle Physiology
Background:
- Sarcopenia, the loss of skeletal muscle mass and strength, is associated with aging and disease.
- Radiologically measured sarcopenia predicts morbidity and mortality in surgical patients.
- The updated European Working Group on Sarcopenia in Older People (EWGSOP) definition includes both muscle strength and mass.
Purpose of the Study:
- To evaluate the prognostic significance of the updated EWGSOP consensus definition of sarcopenia.
- To assess the impact of sarcopenia on outcomes following elective abdominal surgery.
Main Methods:
- Systematic review and meta-analysis of studies published up to June 15, 2022.
- Inclusion of studies comparing sarcopenic and non-sarcopenic patients undergoing elective abdominal surgery.
- Primary outcomes: postoperative morbidity and mortality; secondary analysis: adjusted for confounding factors using QUality in Prognosis Studies (QUIPS) tool.
Main Results:
- Twenty studies involving 5421 patients (1059 sarcopenic) were analyzed.
- Sarcopenic patients faced significantly higher risks of postoperative complications (adjusted OR 1.56).
- Sarcopenia independently predicted increased in-hospital, 30-day, and 90-day mortality, and poorer overall survival (adjusted HR 1.28).
Conclusions:
- Consensus-defined sarcopenia is a crucial prognostic indicator in preoperative abdominal surgery patients.
- Preoperative measurement of sarcopenia is feasible and valuable.
- Interventions to mitigate sarcopenia, such as exercise programs, could enhance surgical outcomes.
