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Meta-Analysis
. 2017 Aug 21;17(1):188.
doi: 10.1186/s12877-017-0569-2.

The impact of frailty and sarcopenia on postoperative outcomes in older patients undergoing gastrectomy surgery: a systematic review and meta-analysis

Yanjiao Shen  1   2   3 , Qiukui Hao  1   3 , Jianghua Zhou  3 , Birong Dong  4   5
Affiliations
Meta-Analysis

The impact of frailty and sarcopenia on postoperative outcomes in older patients undergoing gastrectomy surgery: a systematic review and meta-analysis

Yanjiao Shen et al. BMC Geriatr. .

Abstract

Background: Gastric cancer is a major health problem, and frailty and sarcopenia will affect the postoperative outcomes in older people. However, there is still no systematic review to determine the role of frailty and sarcopenia in predicting postoperative outcomes among older patients with gastric cancer who undergo gastrectomy surgery.

Methods: We searched Embase, Medline through the Ovid interface and PubMed websites to identify potential studies. All the search strategies were run on August 24, 2016. We searched the Google website for unpublished studies on June 1, 2017. The data related to the endpoints of gastrectomy surgery were extracted. Odds ratios (ORs) and their 95% confidence intervals (CIs) were pooled to estimate the association between sarcopenia and adverse postoperative outcomes by using Stata version 11.0. PRISMA guidelines for systematic reviews were followed.

Results: After screening 500 records, we identified eight studies, including three prospective cohort studies and five retrospective cohort studies. Only one study described frailty, and the remaining seven studies described sarcopenia. Frailty was statistically significant for predicting hospital mortality (OR 3.96; 95% CI: 1.12-14.09, P = 0.03). Sarcopenia was also associated with postoperative outcomes (pooled OR 3.12; 95% CI: 2.23-4.37). No significant heterogeneity was observed across these pooled studies (Chi2 = 3.10, I2 = 0%, P = 0.685).

Conclusion: Sarcopenia and frailty seem to have significant adverse impacts on the occurrence of postoperative outcomes. Well-designed prospective cohort studies focusing on frailty and quality of life with a sufficient sample are needed.

Keywords: Frailty; Gastric cancer; Postoperative complications; Sarcopenia.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flowchart of search results and study selection
Fig. 2
Fig. 2
Forest plot of the odds ratios for the association between sarcopenia and postoperative complications of gastric cancer
Fig. 3
Fig. 3
Funnel plot of sarcopenia and postoperative complications of gastric cancer
See this image and copyright information in PMC

References

    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2095–2128. doi: 10.1016/S0140-6736(12)61728-0. - DOI - PMC - PubMed
    1. McCleary NJ, Dotan E, Browner I. Refining the chemotherapy approach for older patients with colon cancer. J Clin Oncol. 2014;32(24):2570–2580. doi: 10.1200/JCO.2014.55.1960. - DOI - PubMed
    1. Pujara D, Mansfield P, Ajani J, Blum M, Elimova E, Chiang YJ, Das P, Badgwell B. Comprehensive geriatric assessment in patients with gastric and gastroesophageal adenocarcinoma undergoing gastrectomy. J Surg Oncol. 2015;112(8):883–887. doi: 10.1002/jso.24077. - DOI - PMC - PubMed
    1. Partridge JS, Harari D, Dhesi JK. Frailty in the older surgical patient: a review. Age Ageing. 2012;41(2):142–147. doi: 10.1093/ageing/afr182. - DOI - PubMed
    1. Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014;9:433–441. - PMC - PubMed