Is Sarcopenia Associated with Worse Postoperative Outcomes following Emergency Laparotomy? A Systematic Review and...

The association between sarcopenia and many postoperative outcomes is not well-established.

This meta-analysis aims to clarify the potential of sarcopenia to predict these postoperative outcomes.

A search of PubMed, EMBASE, and Cochrane CENTRAK databases was performed until November 2023 in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Studies that met the inclusion criteria were extracted and their quality assessment was done using the Newcastle-Ottawa Scale. The pooled analysis was done using a random-effects model with dichotomous outcomes expressed as odds ratio (OR) and continuous as weighted mean differences with 95% confidence intervals (CIs).

Seventeen studies met the inclusion criteria with a total of 5879 patients, with 1690 diagnosed with sarcopenia. Sarcopenia was shown to be significantly associated with increased risk of inpatient mortality (OR = 5.18, 95% CI: 1.04-25.68; P = 0.04), 30-day mortality (OR = 3.32, 95% CI: 2.02-5.46; P < 0.00001), 90-day mortality (OR = 4.24, 95% CI: 1.19-15.12; P = 0.03) and 1-year mortality (OR = 2.53, 95% CI: 1.25-5.12; P = 0.01). Sarcopenic was also associated with an increased risk of severe complications, cardiac complications, pulmonary complications, renal complications, postoperative infections, intensive care unit and hospital length of stay and the risk of unfavorable discharge. There was no significant association between sarcopenia and risk of leakage.

Our meta-analysis provided insights into sarcopenia and postoperative outcomes of emergency surgeries. We demonstrated the significant association between the presence of sarcopenia and the presentation of postoperative adverse outcomes and markers of worsened quality of recovery.