Research in surgery: The adversities that every surgeon should know and face

Jarry, C; Valera, Luca; Navarro, Francisco; Cerdá, Jaime; Grasset, E; Gabrielli, Mauricio

doi:10.1016/j.hsr.2022.100016

Cited by 7 publications

(2 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…NOS score ≥8), which may affect the transferability of the findings synthesized and presented herein. It is worth mentioning that, particularly in the field of surgical research, this phenomenon is well-described and mainly due to the discipline-inherent scarcity of high-quality evidence (including randomized-controlled trials and placebo interventions) and methodological hurdles 358 . However, in order to investigate the validity of our findings, we conducted two types of sensitivity analyses: (i) we restricted the analyses to exclusively high-quality studies, wherein the mortality and complication rates remained significantly higher in the sarcopenia cohort and (ii) we included only studies with prospective data collection in the analyses, which, again, found sarcopenic patients to have a significantly higher mortality and complication occurrence.…”

Section: Discussionmentioning

confidence: 99%

Impact of sarcopenia on outcomes in surgical patients:A systematic review and meta-analysis

Knoedler,

Schliermann,

Knoedler

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

Background: Surgeons have historically used age as a preoperative predictor of postoperative outcomes. Sarcopenia, the loss of skeletal muscle mass due to disease or biological age, has been proposed as a more accurate risk predictor. The prognostic value of sarcopenia assessment in surgical patients remains poorly understood. Therefore, we aimed to synthesize the available literature and investigate the impact of sarcopenia on peri- and postoperative outcomes across all surgical specialties. Methods: We systematically assessed the prognostic value of sarcopenia on postoperative outcomes by conducting a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching the PubMed/MEDLINE and EMBASE databases from inception to 1st October 2022. Our primary outcomes were complication occurrence, mortality, length of operation and hospital stay, discharge to home, and postdischarge survival rate at one, three, and five years. Subgroup analysis was performed by stratifying complications according to the Clavien-Dindo classification system. Sensitivity analysis was performed by focusing on studies with an oncological, cardiovascular, emergency, or transplant surgery population, and on those of higher quality or prospective study design. Results: A total of 294 studies comprising 97,643 patients, of which 33,070 had sarcopenia, were included in our analysis. Sarcopenia was associated with significantly poorer postoperative outcomes including greater mortality, complication occurrence, length of hospital stay, and lower rates of discharge to home (all P<0.00001). A significantly lower survival rate in patients with sarcopenia was noted at one, three, and five years (all P<0.00001) after surgery. Subgroup analysis confirmed higher rates of complications and mortality in oncological (both P<0.00001), cardiovascular (both P<0.00001), and emergency (P=0.03 and P=0.04, respectively) patients with sarcopenia. In the transplant surgery cohort, mortality was significantly higher in patients with sarcopenia (P<0.00001). Among all patients undergoing surgery for inflammatory bowel disease, the frequency of complications was significantly increased among sarcopenic patients (P=0.007). Sensitivity analysis based on higher-quality studies and prospective studies showed that sarcopenia remained a significant predictor of mortality and complication occurrence (all P<0.00001). Conclusion: Sarcopenia is a significant predictor of poorer outcomes in surgical patients. Preoperative assessment of sarcopenia can help surgeons to identify patients at risk, critically balance eligibility, and refine perioperative management. Large-scale studies are required to further validate the importance of sarcopenia as a prognostic indicator of perioperative risk, especially in surgical sub-specialties.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of sarcopenia on outcomes in surgical patients:A systematic review and meta-analysis

Knoedler,

Schliermann,

Knoedler

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…There is evidence in the literature that among the medical specialists, surgeons’ research activities and grant application rates are on a downward trend. [ 6 7 8 ] Our residents are struggling to find research topics. The level of innovation in our surgical practice is low, notwithstanding the contribution of earlier generations of surgeons in West Africa to cutting-edge surgical research.…”

Section: Looking Ahead To the Futurementioning

confidence: 99%