Adverse postoperative outcomes in elderly patients with sarcopenia

Area of Science:

• Geriatric Medicine
• Surgical Outcomes
• Clinical Nutrition

Background:

• Sarcopenia, an age-related loss of muscle mass and strength, is increasingly recognized as a significant health concern in older adults.
• Its impact on postoperative outcomes, particularly in patients undergoing major surgery, requires further investigation.

Purpose of the Study:

• To compare 30-day and 90-day adverse postoperative outcomes and mortality between elderly patients with and without sarcopenia undergoing major surgery.
• To determine if sarcopenia is an independent risk factor for these outcomes.

Main Methods:

• A propensity score-matched (PSM) cohort study was conducted.
• Elderly patients undergoing major surgery were categorized into two groups: with and without preoperative sarcopenia (1:4 ratio).
• 30-day and 90-day adverse postoperative outcomes and mortality were analyzed.

Main Results:

• Patients with preoperative sarcopenia exhibited significantly higher risks of 30-day mortality (aOR=1.25) and major complications like pneumonia, bleeding, and septicemia.
• Sarcopenic patients also faced significantly higher risks of 90-day mortality (aOR=1.50) and major complications, including pneumonia, bleeding, and septicemia.
• Sarcopenia was identified as an independent risk factor for both 30-day and 90-day adverse postoperative outcomes and mortality.

Conclusions:

• Preoperative sarcopenia is a significant independent risk factor for adverse postoperative outcomes and mortality following major surgery.
• These outcomes include increased risks of pneumonia, postoperative bleeding, and septicemia within 30 and 90 days.
• Interventions to correct sarcopenia, improve swallowing, and enhance respiratory muscle function before elective surgery are recommended to reduce complications and surgical mortality.