-
Annals of Nutrition & Metabolism 2019Computed tomography (CT)-assessed sarcopenia indexes have been reported to predict postoperative morbidity and mortality; however conclusions drawn from different... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Computed tomography (CT)-assessed sarcopenia indexes have been reported to predict postoperative morbidity and mortality; however conclusions drawn from different indexes and studies remain controversial.
AIM
The purpose of this meta-analysis was to evaluate various CT-assessed sarcopenia indexes as predictors of risk for major complications in patients undergoing hepatopancreatobiliary surgery for malignancy.
METHODS
Medline/PubMed, Web of Science, and Embase databases were systematically searched to identify relevant studies published before June 2018. PRISMA guidelines for systematic reviews were followed. The pooled risk ratio (RR) for major postoperative complications (Clavien-Dindo ≥III) was estimated in patients with sarcopenia versus patients without sarcopenia. Data extracted were meta-analyzed using Review Manager (version 5.3).
RESULTS
Twenty-eight studies comprising 6,656 patients were included in this study. CT-assessed sarcopenia indexes, such as skeletal muscle index (SMI, RR 1.36; 95% CI 1.14-1.63; p = 0.0008; I2 = 24%), psoas muscle index (PMI, RR 1.35; 95% CI 1.15-1.58; p = 0.0002; I2 = 0%), muscle attenuation (MA, RR 1.40; 95% CI 1.14-1.73; p = 0.002; I2 = 4%), and intramuscular adipose tissue content (IMAC, RR 1.63; 95% CI 1.28-2.09; p < 0.0001; I2 = 0%) were all predictors of postoperative major complications, although moderate heterogeneity existed and cutoffs for these indexes to define sarcopenia varied.
CONCLUSIONS
All commonly used CT-assessed sarcopenia indexes, such as SMI, PMI, MA, and IMAC can predict the risk of major postoperative complications; however, a consensus on the cutoffs for these indexes to define sarcopenia is still lacking.
Topics: Adipose Tissue; Digestive System Neoplasms; Digestive System Surgical Procedures; Humans; Morbidity; Muscle, Skeletal; Postoperative Complications; Risk Factors; Sarcopenia; Tomography, X-Ray Computed
PubMed: 30513518
DOI: 10.1159/000494887 -
BMC Geriatrics Sep 2021The development of sarcopenia is attributed to normal aging and factors like type 2 diabetes, obesity, inactivity, reduced testosterone levels, and malnutrition, which... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The development of sarcopenia is attributed to normal aging and factors like type 2 diabetes, obesity, inactivity, reduced testosterone levels, and malnutrition, which are factors of poor prognosis in patients with coronary artery disease (CAD). This study aimed to perform a meta-analysis to assess whether preoperative sarcopenia can be used to predict the outcomes after cardiac surgery in elderly patients with CAD.
METHODS
PubMed, Embase, the Cochrane library, and Web of Science were searched for available papers published up to December 2020. The primary outcome was major adverse cardiovascular outcomes (MACE). The secondary outcomes were mortality and heart failure (HF)-related hospitalization. The random-effects model was used. Hazard ratios (HRs) with 95% confidence intervals (95%CIs) were estimated.
RESULTS
Ten studies were included, with 3707 patients followed for 6 months to 4.5 ± 2.3 years. The sarcopenia population had a higher rate of MACE compared to the non-sarcopenia population (HR = 2.27, 95%CI: 1.58-3.27, P < 0.001; I = 60.0%, P = 0.02). The association between sarcopenia and MACE was significant when using the psoas muscle area index (PMI) to define sarcopenia (HR = 2.86, 95%CI: 1.84-4.46, P < 0.001; I = 0%, P = 0.604). Sarcopenia was not associated with higher late mortality (HR = 2.15, 95%CI: 0.89-5.22, P = 0.090; I = 91.0%, P < 0.001), all-cause mortality (HR = 1.35, 95%CI: 0.14-12.84, P = 0.792; I = 90.5%, P = 0.001), and death, HF-related hospitalization (HR = 1.37, 95%CI: 0.59-3.16, P = 0.459; I = 62.0%, P = 0.105). The sensitivity analysis revealed no outlying study in the analysis of the association between sarcopenia and MACE after coronary intervention.
CONCLUSION
Sarcopenia is associated with poor MACE outcomes in patients with CAD. The results could help determine subpopulations of patients needing special monitoring after CAD surgery. The present study included several kinds of participants; although non-heterogeneity was found, interpretation should be cautious.
Topics: Aged; Coronary Artery Disease; Diabetes Mellitus, Type 2; Humans; Proportional Hazards Models; Sarcopenia
PubMed: 34521369
DOI: 10.1186/s12877-021-02438-w -
Oncotarget Nov 2017The impact of sarcopenia on outcomes following treatment for primary liver tumors remains contentious. Therefore, we performed a systematic literature review and...
BACKGROUND
The impact of sarcopenia on outcomes following treatment for primary liver tumors remains contentious. Therefore, we performed a systematic literature review and meta-analysis to evaluate the clinical significance of sarcopenia in the treatment of patients with primary liver tumors.
DATA SOURCES
A systematic literature search was performed in English through February 1, 2017 in databases.
RESULTS
There were significant differences between patients with and without sarcopenia in overall 1- and 3-year survival (1 year: OR: 0.43; 95% CI: 0.27-0.68; =0.0004; 3 year: OR: 0.67; 95% CI: 0.47-0.96; =0.03). However, overall 5-year survival showed no significant difference between the groups (OR: 0.61; 95% CI: 0.35-1.07; =0.08). Patients with sarcopenia showed a significant 53% reduction in disease-free survival within 5 years (OR: 0.47; 95% CI: 0.28-0.79; =0.005). Also, sarcopenia had a significantly negative impact on recurrence in patients with primary liver tumors (RR: 2.71; 95% CI: 1.46-5.05; =0.002). Regarding complications rate, we concluded that there was a statistically significant difference between two groups in overall complications rate (RR: 2.52; 95% CI: 1.50-4.22; =0.0005). However, the major complications rate showed no significant difference between the groups (RR: 1.19; 95% CI: 0.65-2.20; =0.57).
CONCLUSIONS
Sarcopenia seemed to have a negative effect on overall survival in patients with primary liver tumors in the early phase post-treatment, but further research is needed to investigate the prognostic impact on overall survival over the longer term. Moreover, sarcopenia could significantly increase the incidence rates of post-treatment recurrence and overall complications in patients with primary liver tumors.
PubMed: 29254263
DOI: 10.18632/oncotarget.19687