Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Jul 12;25(1):520.
doi: 10.1186/s12877-025-06183-2.

Association between sarcopenia and postoperative delirium in elderly surgical patients: a systematic review and meta-analysis

Yunying Feng #  1   2 , Ruixiao Sun #  3   4 , Yuelun Zhang  5 , Lulu Ma  6   7 , Yuguang Huang  1   2 , Kang Yu  8
Affiliations
Meta-Analysis

Association between sarcopenia and postoperative delirium in elderly surgical patients: a systematic review and meta-analysis

Yunying Feng et al. BMC Geriatr. .

Abstract

Background: Sarcopenia, characterized by the progressive loss of muscle mass and strength, is common in the elderly and significantly increases the risk of poor postoperative outcomes. This study aims to examine the impact of sarcopenia on postoperative delirium and a range of perioperative outcomes in elderly patients.

Methods: A systematic search was conducted in MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL. Studies investigating the association between sarcopenia and postoperative complications in elderly surgical patients were included. The Quality in Prognosis Studies (QUIPS) tool was utilized for risk-of-bias assessment. The primary outcome was the incidence of postoperative delirium. Secondary outcomes included other postoperative complications and further recovery. Subgroup analyses were conducted based on surgery types.

Results: A total of 10,981 records were identified, with 265 studies included in the systematic review and 242 in the final meta-analysis. A significant association was found between sarcopenia and postoperative delirium in both univariable and multivariable analyses (univariable: OR 1.81, 95% confidence interval [CI] 1.31 to 2.50, P < 0.001, I2 24.0%; multivariable: OR 2.42, 95% CI 1.27 to 4.59, P = 0.007, I2 0.0%). Sarcopenia was also associated with adverse postoperative outcomes, including increased complications, mortality, delayed recovery, and reduced overall survival. However, no significant associations were observed for postoperative pancreatic fistula or recurrence. Syntheses of multivariable analyses showed significant differences in postoperative complications, mortality, overall survival, and recurrence. Subgroup analyses indicated a higher risk of reduced overall survival among sarcopenic patients undergoing head and neck or heart and chest surgeries.

Conclusions: Sarcopenia is a strong independent predictor of postoperative delirium and poor postoperative outcomes in elderly surgical patients.

Systematic review registration: PROSPERO registration number CRD42023424696 (18 May 2023).

Keywords: Evidence synthesis; Postoperative complications; Postoperative delirium; Sarcopenia; Surgery.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Risk-of-bias graph
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet. 2015;385(Suppl 2):S11. - PubMed
    1. NHS Digital. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/hos.... Cited September 1, 2024.
    1. Kwok AC, Semel ME, Lipsitz SR, Bader AM, Barnato AE, Gawande AA, et al. The intensity and variation of surgical care at the end of life: a retrospective cohort study. Lancet. 2011;378(9800):1408–13. - PubMed
    1. Daiello LA, Racine AM, Yun Gou R, Marcantonio ER, Xie Z, Kunze LJ, et al. Postoperative delirium and postoperative cognitive dysfunction: overlap and divergence. Anesthesiology. 2019;131(3):477–91. - PMC - PubMed
    1. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911–22. - PMC - PubMed

LinkOut - more resources