Effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications in elderly patients with colorectal cancer: A prospective study

Chen, W S; Huang, Yueyue; Xu, Liping; Shi, Mingming; Chen, X D; Ye, G Q; Wu, Tao; Zhu, Guanbao

doi:10.4149/neo_2020_190908n882

Cited by 11 publications

(7 citation statements)

References 57 publications

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“…In the context of CRC, BSA has been characterized as a prognostic factor linked with survival and a predictor of surgical morbidity and death. [6,9,10]…”

Section: Introductionmentioning

confidence: 99%

“…In the context of CRC, BSA has been characterized as a prognostic factor linked with survival and a predictor of surgical morbidity and death. [6,9,10] BSA measurement is simple, affordable, accurate, and trustworthy, frequently used to determine patients general state with many types of medical conditions. Consequently, we aimed to evaluate the predictive value of preoperative hypoalbuminemia in patients undergoing colorectal surgery.…”

Section: Introductionmentioning

confidence: 99%

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Hypoalbuminemia and colorectal cancer patients: Any correlation?: A systematic review and meta-analysis

et al. 2023

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Background: In malnourished patients with colorectal cancer, hypoalbuminemia is common and was proposed to determine the postoperative outcome of colorectal surgery. Mounting articles published but have not been evaluated. We aim to assess the predictive value of preoperative hypoalbuminemia in patients undergoing colorectal surgery.Methods: We performed a literature search from PubMed, Euro PMC, and Cochrane with the terms serum albumin, hypoalbuminemia, prognosis, outcome, colorectal cancer, and neoplasm. We also hand-searched and included any relevant papers. Hypoalbuminemia is defined as plasma albumin level < 3.5 mg/dL. We restricted the included studies to English language and adults undergoing colectomy, laparotomy, laparoscopy, or abdominoperineal resection. Any types of articles were included, except an abstract-only publication and those that did not report the key exposure or outcome of interest. The key exposures were mortality, hospitalization time, and morbid conditions (thrombosis, surgical site infection, sepsis, and wound events). We pooled the odds ratio from each included literature as effect size. The Newcastle Ottawa scale and GRADE were used to determine the quality of each included study.Results: Hereof 7 observational studies (236,480 individuals) were included. Our meta-analysis found that preoperative hypoalbuminemia can predict the postoperative outcome in colorectal cancer patients. Individuals with hypoalbuminemia were not associated with 30-day mortality (risk ratio [RR] 2.05 [0.72, 5.86], P = .18, I 2 = 99%) but were associated with morbidity (RR 2.28 [1.78,2.93], P < .00001, I 2 = 87.5%), surgical complication (RR 1.69 [1.34,2.13], P < .00001, I 2 = 98%), and hospitalization (RR 2.21 [1.93,2.52], P < .00001, I 2 = 0%). According to newcastle ottawa scale, the included studies are of moderate to sound quality. Conclusions:The current systematic review and meta-analysis showed that preoperative hypoalbuminemia was significantly associated with morbidity, length of stay, and surgical complication but not mortality.Abbreviations: BSA = basal serum albumin, CRC = colorectal cancer, NOS = newcastle ottawa scale, RR = risk ratio.

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“…In the context of CRC, BSA has been characterized as a prognostic factor linked with survival and a predictor of surgical morbidity and death. [6,9,10]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypoalbuminemia and colorectal cancer patients: Any correlation?: A systematic review and meta-analysis

et al. 2023

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“…Previous investigations studying the synergistic impact of sarcopenia and hypoalbuminemia on clinical outcomes have largely been conducted for other clinical applications, yet they report similar findings. 27 , 28 , 29 , 30 Few mechanisms have been proposed that may explain this association. Importantly, both hypoalbuminemia and sarcopenia are associated with chronic diseases and advanced age, as well as each other.…”

Section: Discussionmentioning

confidence: 99%

“…However, the combined effects of hypoalbuminemia and sarcopenia on adverse outcomes have been described in other contexts, such as incident disability, postoperative complications in colorectal cancer and renal cell carcinoma, and survival after infrainguinal revascularization. 27 , 28 , 29 , 30 In the present study, we aimed to investigate the combined effects of LMM as a surrogate for sarcopenia and admission hypoalbuminemia on in‐hospital outcomes of patients with ADHF; we also aimed to study the impact of LMM combined with improvement in albumin during hospitalization or discharge hypoalbuminemia on postdischarge outcomes.…”

mentioning

confidence: 99%

Combined Prognostic Impact of Low Muscle Mass and Hypoalbuminemia in Patients Hospitalized for Heart Failure: A Retrospective Cohort Study

Mirzai,

Sarnaik,

Persits

et al. 2024

JAHA

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Background Sarcopenia and hypoalbuminemia have been identified as independent predictors of increased adverse outcomes, including mortality and readmissions, in hospitalized older adults with acute decompensated heart failure (ADHF). However, the impact of coexisting sarcopenia and hypoalbuminemia on morbidity and death in adults with ADHF has not yet been investigated. We aimed to investigate the combined effects of lower muscle mass (LMM) as a surrogate for sarcopenia and hypoalbuminemia on in‐hospital and postdischarge outcomes of patients hospitalized for ADHF. Methods and Results A total of 385 patients admitted for ADHF between 2017 and 2020 at a single institution were retrospectively identified. Demographic and clinical data were collected, including serum albumin levels at admission and discharge. Skeletal muscle indices were derived from semi‐automated segmentation software analysis on axial chest computed tomography at the twelfth vertebral level. Our analysis revealed that patients who had LMM with admission hypoalbuminemia experienced increased diagnoses of infection and delirium with longer hospital length of stay and more frequent discharge to a facility. Upon discharge, 27.9% of patients had higher muscle mass without discharge hypoalbuminemia (reference group), 9.7% had LMM without discharge hypoalbuminemia, 38.4% had higher muscle mass with discharge hypoalbuminemia, and 24.0% had LMM with discharge hypoalbuminemia; mortality rates were 37.6%, 51.4%, 48.9%, and 63.2%, respectively. 1‐ and 3‐year mortality risks were highest in those with LMM and discharge hypoalbuminemia; this relationship remained significant over a median 23.6 (3.1–33.8) months follow‐up time despite multivariable adjustments (hazard ratio, 2.03 [95% CI, 1.31–3.16]; P =0.002). Conclusions Hospitalization with ADHF, LMM, and hypoalbuminemia portend heightened mortality risk.

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“…[11][12][13][14] Many studies reported that high NLR, low hemoglobin, and low serum albumin levels show an unfavorable prognosis in lung cancer. [15][16][17] Additionally, many studies have shown that blood values such, as white blood cell count, neutrophil count, and NLR, are valuable in predicting prognosis, mortality, complications, and hospital stay in cardiovascular diseases. [18][19][20] We hypothesize that various scoring systems and laboratory parameters may be more effective in predicting PPCs in patients undergoing thoracic surgery.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of ARISCAT Risk Index, other scoring systems, and parameters in predicting pulmonary complications after thoracic surgery

et al. 2022

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The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk index, which is frequently used in nonthoracic surgery, may not be sufficient to predict postoperative pulmonary complications (PPCs). We aimed to evaluate the effectiveness of the ARISCAT risk index, ASA, preoperative albumin level, neutrophil/lymphocyte ratio (NLR), and other parameters in predicting PPCs after thoracic surgery.Patients undergoing elective thoracic surgery with 1-lung ventilation (OLV) were prospectively analyzed. Demographic data, ARISCAT score, ASA, Nutritional Risk Score-2002, NLR, white blood cell counts, albumin, hemoglobin levels, intraoperative complications, postoperative average visual analogue scale (VAS) score for pain at the 24 th -hour, the length of stay in the postoperative intensive care unit, chest tube removal time, postoperative complications, and discharge time were recorded. Patients were assessed for morbidity and mortality on the 90 th -day. 120 patients' data were analyzed. PPCs developed in 26 patients. The development of PPCs was statistically significant in patients with high ARISCAT scores (P = .002), high ARISCAT grades (P = .009), and ASA III (P = .002). The albumin level was statistically significantly lower in patients who had mortality within 3 months (P = .007). When scoring systems and laboratory parameters were evaluated together, patients with high ARISCAT grade, Albumin < 35g/L, and ASA III had significantly higher development of PPCs (P = .004).ARISCAT risk index and ASA were found to be significant in predicting PPCs after thoracic surgery. They were also valuable when evaluated in combination with preoperative albumin levels. Additionally; age, male gender, duration of surgery, and duration of OLV were also found to be associated with PPCs.

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Effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications in elderly patients with colorectal cancer: A prospective study

Cited by 11 publications

References 57 publications

Hypoalbuminemia and colorectal cancer patients: Any correlation?: A systematic review and meta-analysis

Hypoalbuminemia and colorectal cancer patients: Any correlation?: A systematic review and meta-analysis

Combined Prognostic Impact of Low Muscle Mass and Hypoalbuminemia in Patients Hospitalized for Heart Failure: A Retrospective Cohort Study

The effectiveness of ARISCAT Risk Index, other scoring systems, and parameters in predicting pulmonary complications after thoracic surgery

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