Short- and long-term impact of sarcopenia on outcomes after emergency laparotomy: A systematic review and meta-analysis

Park, Brittany; Bhat, Sameer; Wells, Cameron I.; Barazanchi, Ahmed; Hill, Andrew; MacCormick, Andrew D.

doi:10.1016/j.surg.2022.02.014

Cited by 9 publications

(13 citation statements)

References 64 publications

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“…Sarcopenia has been recognized as one of the key elements of frailty and is associated with poorer surgical outcomes. Pre‐operative sarcopenia as measured with CT data has been consistently demonstrated to be associated with higher post‐operative mortality after EL, 1–20 and further verified in systematic reviews and meta‐analyses 21–24 . One of the reported ways to quantify sarcopenia is via analysis of CT scans to measure the ratio of the cross‐sectional area of psoas muscle to the area of the L3 vertebral body.…”

Section: Introductionmentioning

confidence: 91%

“…Preoperative sarcopenia as measured with CT data has been consistently demonstrated to be associated with higher post-operative mortality after EL, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] and further verified in systematic reviews and meta-analyses. [21][22][23][24] One of the reported ways to quantify sarcopenia is via analysis of CT scans to measure the ratio of the cross-sectional area of psoas muscle to the area of the L3 vertebral body. Such CT scan analysis is practical and efficient in the setting of assessing an acutely unwell patient, and can potentially be routinely reported by the radiologist.…”

Section: Introductionmentioning

confidence: 99%

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Combining sarcopenia and ASA status to inform emergency laparotomy outcomes: could it be that simple?

Ming

Howley

Holmes

et al. 2023

ANZ Journal of Surgery

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Background Risk assessment for emergency laparotomy (EL) is important for guiding decision‐making and anticipating the level of perioperative care in acute clinical settings. While established tools such as the American College of Surgeons National Surgical Quality Improvement Program calculator (ACS‐NSQIP), the National Emergency Laparotomy Audit Risk Prediction Calculator (NELA) and the Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity calculation (P‐POSSUM) are accurate predictors for mortality, there has been increasing recognition of the benefits from including measurements for frailty in a simple and quantifiable manner. Psoas muscle to 3rd lumbar vertebra area ratio (PM:L3) measured on CT scans was proven to have a significant inverse association with 30‐, 90‐ and 365‐day mortality in EL patients. Methods A retrospective analysis was conducted of 500 patients admitted to four Australian hospitals who underwent EL during 2016–2017, and had contemporaneous abdomino‐pelvic CT scans. Radiological sarcopenia was measured as PM:L3 ratios. ASC‐NSQIP, NELA and P‐POSSUM were retrospectively calculated. Univariate and multivariate logistic regression modelling was used to assess these ratios and scores, as well as American Society of Anaesthesiologists (ASA) classification separated into ASA I‐III and IV/V (simplified ASA), as potential predictors of 30‐, 90‐ and 365‐day mortality. Results PM:L3, simplified ASA, ACS‐NSQIP, NELA and P‐POSSUM were each statistically significant predictors of 30‐day, 90‐day and 365‐day mortality (P < 0.001). Logistic regression models of 30‐, 90‐ and 365‐day mortality combining PM:L3 (P = 0.001) and simplified ASA (P < 0.001) exhibited AUCs of 0.838 (0.780, 0.896), 0.805 (0.751, 0.860) and 0.775 (0.729, 0.822), respectively, which were comparable to that of ACS‐NSQIP and NELA. Conclusion Combining the semi‐physiological parameter ASA classification with PM:L3 provides a quick and simple alternative to the more complex established risk assessment scores and is superior to PM:L3 alone.

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Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Combining sarcopenia and ASA status to inform emergency laparotomy outcomes: could it be that simple?

Ming

Howley

Holmes

et al. 2023

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Park et al review study previously analysed the effects of sarcopenia on emergency laparotomy outcomes, however we highlight the variation in sarcopenia marker cut off values and how sarcopenia was defined in each study. 27 Furthermore, most studies in our review also relied on the investigated cohort's lowest quartile values, which in itself may be subject to sampling bias. Finally, the various country origins of the investigated suggest that the cohorts were likely composed of different ethnicities, requiring differing threshold values of sarcopenia markers.…”

Section: Retrospectivementioning

confidence: 99%

Markers of sarcopenia increase 30-day mortality following emergency laparotomy: A systematic review

Brzeszczyński

Brzeszczyńska

2022

Scand J Surg

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Background and objective: Decreased skeletal muscle mass and quality are one of the several markers used for sarcopenia diagnosis and are generally associated with increased rates of post-operative infections, poorer recovery and increased mortality. The aim of this review was to evaluate methods applied to detect markers of sarcopenia and the associated outcomes for patients undergoing emergency laparotomy. Methods: This review was conducted with reference to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. MEDLINE, Embase and Google Scholar databases were searched. Studies detecting patients with sarcopenia or skeletal muscle decline markers and the associated outcomes after emergency laparotomy surgery were considered. The Newcastle–Ottawa Scale was used to evaluate publication quality. Results: Out of 103 studies, which were screened, 19 full-text records were reviewed and 7 studies were ultimately analyzed. The study cohort sizes ranged from n = 46 to n = 967. The age range was 36–95 years. There were 1107 females (53%) and 973 males (47%) across all 7 studies. All studies measured psoas muscle mass and three studies assessed psoas muscle quality using computerized tomography (CT) imaging. No study assessed muscle strength or function, while five studies showed an association between low muscle mass and increased mortality rates after emergency laparotomy. Among the three studies, which assessed muscle quality, two of three studies showed poorer 30-day survival rates. Conclusions: The existing literature is limited, however it indicates that low psoas muscle mass and quality markers are associated with increased 30-day mortality rates after emergency laparotomy. Therefore, muscle markers can be used as a new feasible tool to identify most at risk patients requiring further interventions.

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“…In recent years, with the coming of the aging society, the prevalence of sarcopenia was increasing to 29% in older adults, and for those aged more than 80 years, the number was about 50% (4). Patients with sarcopenia may face an increased risk of falls, fractures, rehospitalization, and even death, due to the decrease in muscle mass and function (5). Many studies have found that many factors may contribute to the development of sarcopenia, such as nutrition status (6), changes in the types of hormones (7), chronic inflammation (8), and mitochondrial dysfunction (9).…”

Section: Introductionmentioning

confidence: 99%

Bibliometric analysis of research trends in relationship between sarcopenia and surgery

Liu

Song

et al. 2023

Front. Surg.

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BackgroundThe relationship between sarcopenia and surgery has attracted an increasing number of researchers in recent years. Our study aimed to identify the current research hotspot and status in this field by using bibliometric and visualization analysis.MethodsPublications about the relationship between sarcopenia and surgery that met the inclusion criteria were collected from the Science Citation Index Expanded. The bibliometric and visualized studies were performed using VOSviewer, and R.ResultsA total of 2,261 documents on the relationship between sarcopenia and surgery were included in our study. These articles were written by 13,757 authors from 2,703 institutions in 70 countries and were published in 772 journals. The USA is the most productive and influential country in this field (524 publications and 15,220 citations). The Udice French Research Universities was the most productive institution in this field (57 publications), and the University of Alberta had the largest number of citations. Annuals of Surgical Oncology published the most studies in this field. Shen Xian was the most productive author in this field (number of publications = 19), and Baracos Vickie was the most influential author, whose studies in this field had been cited 2,209 times. The cluster analysis was performed and visualized, and the keywords were classified into 6 clusters: Cluster 1 (body composition and nutrition), Cluster 2 (sarcopenia), Cluster 3 (malnutrition and cachexia), Cluster 4 (cancer surgery), Cluster 5 (elderly and frailty), Cluster 6 (neuromuscular scoliosis).ConclusionThe relationship between sarcopenia and surgery was still a controversial and well-discussed topic in recent years. Our study showed that the study in this field mainly focused on sarcopenia, oncology surgery, orthopedics, and nutrition.

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Short- and long-term impact of sarcopenia on outcomes after emergency laparotomy: A systematic review and meta-analysis

Cited by 9 publications

References 64 publications

Combining sarcopenia and ASA status to inform emergency laparotomy outcomes: could it be that simple?

Combining sarcopenia and ASA status to inform emergency laparotomy outcomes: could it be that simple?

Markers of sarcopenia increase 30-day mortality following emergency laparotomy: A systematic review

Bibliometric analysis of research trends in relationship between sarcopenia and surgery

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