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


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2020
Historique:
received: 16 06 2020
accepted: 31 07 2020
entrez: 22 8 2020
pubmed: 22 8 2020
medline: 21 10 2020
Statut: epublish

Résumé

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. 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. 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). 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.

Sections du résumé

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.

Identifiants

pubmed: 32822372
doi: 10.1371/journal.pone.0237740
pii: PONE-D-20-18203
pmc: PMC7446889
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0237740

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Leonardo Zumerkorn Pipek (LZ)

Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil.

Carlos Guilherme Baptista (CG)

Departamento de Gastroenterologia, Hospital das Clínicas, HCFMUSP, São Paulo, Brazil.

Rafaela Farias Vidigal Nascimento (RFV)

Faculdade de Medicina do ABC - Centro Universitário Saúde ABC, Santo André, São Paulo, Brasil.

João Victor Taba (JV)

Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil.

Milena Oliveira Suzuki (MO)

Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil.

Fernanda Sayuri do Nascimento (FS)

Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil.

Diego Ramos Martines (DR)

Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil.

Fernanda Nii (F)

Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, São Paulo, Brazil.

Leandro Ryuchi Iuamoto (LR)

Department of Orthopaedics and Traumatology, Center of Acupuncture, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.

Luiz Augusto Carneiro-D'Albuquerque (LA)

Departamento de Gastroenterologia, Hospital das Clínicas, HCFMUSP, São Paulo, Brazil.

Alberto Meyer (A)

Departamento de Gastroenterologia, Hospital das Clínicas, HCFMUSP, São Paulo, Brazil.

Wellington Andraus (W)

Departamento de Gastroenterologia, Hospital das Clínicas, HCFMUSP, São Paulo, Brazil.

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