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Meta-Analysis
. 2020 Aug 21;15(8):e0237740.
doi: 10.1371/journal.pone.0237740. eCollection 2020.

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

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

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

Leonardo Zumerkorn Pipek et al. PLoS One. .

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Data search flow.
Fig 2
Fig 2. Most used classifications for sarcopenia.
EWGSOP2 and AWGS form the criteria selected for inclusion in this systematic review and meta-analysis.
Fig 3
Fig 3. Forest plot of the publications analysed in relation to sarcopenia and post-surgical complications.
Fig 4
Fig 4. Publication bias for studies that assessed sarcopenia as a factor associated with post-surgical complications.
Fig 5
Fig 5. Forest plot of the publications analysed regarding sarcopenia and hospital readmission (30 days).
Fig 6
Fig 6. Publication bias for studies that assessed sarcopenia as a factor associated with hospital readmission (30 days).
See this image and copyright information in PMC

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