The impact of properly diagnosed sarcopenia on postoperative outcomes after gastrointestinal surgery: A systematic review and meta-analysis

Author(s):Show less -

Pipek, Leonardo Zumerkorn ^[1] ; Baptista, Carlos Guilherme ^[2] ; Vidigal Nascimento, Rafaela Farias ^[3] ; Taba, Joao Victor ^[1] ; Suzuki, Milena Oliveira ^[1] ; do Nascimento, Fernanda Sayuri ^[1] ; Martines, Diego Ramos ^[1] ; Nii, Fernanda ^[1] ; Iuamoto, Leandro Ryuchi ^[4] ; Carneiro-D'Albuquerque, Luiz Augusto ^[2] ; Meyer, Alberto ^[2] ; Andraus, Wellington ^[2]

Affiliation

^[1] Univ Sao Paulo, Fac Med FMUSP, Sao Paulo, SP - Brazil

^[2] Hosp Clin Sao Paulo, Dept Gastroenterol, HCFMUSP, Sao Paulo - Brazil

^[3] Ctr Univ Saude ABC, Fac Med ABC, Santo Andre, SP - Brazil

^[4] Univ Sao Paulo, Ctr Acupuncture, Dept Orthopaed & Traumatol, Sch Med, Sao Paulo - Brazil

• Document type: Review article
• Source: PLoS One; v. 15, n. 8 AUG 21 2020.
• Web of Science Citations: 0

Abstract

Background Sarcopenia is defined as the loss of muscle mass combined with loss of muscle strength, with or without loss of muscle performance. The use of this parameter as a risk factor for complications after surgery is not currently used. This meta-analysis aims to assess the impact of sarcopenia defined by radiologically and clinically criteria and its relationship with complications after gastrointestinal surgeries. Materials and methods A review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration number: CRD42019132221). Articles were selected from the PUBMED and EMBASE databases that adequately assessed sarcopenia and its impact on postoperative complications in gastrointestinal surgery patients. Pooled estimates of pre-operative outcome data were calculated using the odds ratio (OR) and 95% confidence interval (CI). Subgroup analysis were performed to assess each type of surgery. Results The search strategy returned 1323, with 11 studies meeting the inclusion criteria. A total of 4265 patients were analysed. The prevalence of sarcopenia between studies ranged from 6.8% to 35.9%. The meta-analysis showed an OR for complications after surgery of 3.01 (95% CI 2.55-3.55) and an OR of 2.2 (95% CI 1.44-3.36) for hospital readmission (30 days). Conclusion Sarcopenia, when properly diagnosed, is associated with an increase in late postoperative complications, as well as an increase in the number of postoperative hospital readmissions for various types of gastrointestinal surgery. We believe that any preoperative evaluation should include, in a patient at risk, tests for the diagnosis of sarcopenia and appropriate procedures to reduce its impact on the patient's health. (AU)

• FAPESP's process: 18/10430-6 - Prevalence of sarcopenia in cirrhotic patients with abdominal hernia
• Grantee: Diego Ramos Martines
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 18/10423-0 - Prevalence of sarcopenia in cirrhotic patients with abdominal hernia
• Grantee: Fernanda Nii
• Support Opportunities: Scholarships in Brazil - Scientific Initiation