Sarcopenia as an independent predictor of the surgical outcomes of patients with inflammatory bowel disease: a meta-analysis

Erős, Adrienn; Soós, Alexandra; Hegyi, Péter; Benke, Márton; Szücs, Ákos; Hartmann, Petra; Patrícia, Silvia

doi:10.1007/s00595-019-01893-8

Cited by 53 publications

(57 citation statements)

References 45 publications

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“…It was found that IBD patients with sarcopenia had a higher probability of requiring surgery and significantly higher rates of major complications [ 9 ]. There are a number of studies that support these findings in terms of sarcopenia as a predictor of surgical intervention and reduced operation-free survival [ 20 , 24 , 128 , 129 ]. Indeed, there is an increase in post-surgical infections in those with sarcopenia, specifically surgical-site infections after restorative proctocolectomy for UC [ 130 ] and abscesses following intestinal surgery in CD [ 131 ].…”

Section: The Management Of Sarcopeniamentioning

confidence: 96%

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

et al. 2021

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Malnutrition is a common condition encountered in patients with inflammatory bowel disease (IBD) and is often associated with sarcopenia (the reduction of muscle mass and strength) which is an ever-growing consideration in chronic diseases. Recent data suggest the prevalence of sarcopenia is 52% and 37% in Crohn’s disease and ulcerative colitis, respectively, however it is challenging to fully appreciate the prevalence of sarcopenia in IBD. Sarcopenia is an important consideration in the management of IBD, including the impact on quality of life, prognostication, and treatment such as surgical interventions, biologics and immunomodulators. There is evolving research in many chronic inflammatory states, such as chronic liver disease and rheumatoid arthritis, whereby interventions have begun to be developed to counteract sarcopenia. The purpose of this review is to evaluate the current literature regarding the impact of sarcopenia in the management of IBD, from mechanistic drivers through to assessment and management.

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Section: The Management Of Sarcopeniamentioning

confidence: 96%

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

et al. 2021

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“…Sarcopenia may serve as an independent predictor of the surgical outcomes of patients with inflammatory bowel disease and is closely related to the increased incidence of postoperative complications. The CD patients with sarcopenia often have compromised muscular strength and quality of life (11,12).…”

Section: Introductionmentioning

confidence: 99%

Role of Human Body Composition Analysis and Malnutrition Risk Questionnaire in the Assessment of Nutritional Status of Patients With Initially Diagnosed Crohn's Disease

et al. 2020

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Objective: This study was carried out to investigate the role and necessity of human body composition analysis in assessing the nutritional status of initially diagnosed Crohn's disease (CD) patients.Methods: A total of 47 initially diagnosed CD patients were recruited. The skeletal muscle mass index (SMI), fat-free mass index (FFMI), body fat mass, body fat percent, visceral fat area (VFA), and body cell mass were determined with the Biospace Inbody S10 composition analyzer.Results: In 47 patients with initially diagnosed CD, SMI could determine the muscular mass reduction that could not be determined by the body mass index (BMI) (35.3%), albumin (ALB) (65.6%), nutrition risk screening (NRS)2002 (25.0%), and Patient-Generated Subjective Global Assessment (PG-SGA) (55.6%). FFMI could determine the malnutrition that could not be determined by the BMI (58.8%), albumin (90.6%), NRS2002 (50.0%), and PG-SGA (55.6%). VFA in the fistulizing CD patients was significantly higher than in the stricturing and non-fistulizing, non-stricturing patients (P < 0.05). SMI and BMI had the same performance (P = 1.000) and general consistence (Kappa = 0.487, P = 0.001) in the assessment of malnutrition; SMI and ALB had different performance (P < 0.001) and inconsistence was noted (Kappa = 0.069, P = 0.489) in the assessment of malnutrition; the results of the nutrition assessment were different between SMI and NRS2002 (P = 0.002), and inconsistence was observed (Kappa = 0.190, P = 0.071). SMI and PG-SGA had the same performance in the assessment of nutrition (P = 0.143), but there was inconsistence (Kappa = 0.099, P = 0.464). FFMI and BMI had general consistence in the assessment of malnutrition (Kappa = 0.472, P < 0.001), but the positive rate determined by FFMI (85.1%) was markedly higher than that by BMI (63.8%) (P = 0.002). FFMI and ALB had different performance in the assessment of malnutrition Kurban et al. Nutritional Status of Patients With CD(P < 0.001) and there was inconsistence (Kappa = −0.008, P = 0.877). FFMI and NRS2002 had the same performance in the assessment of malnutrition (P = 0.453), but the consistence was poor (Kappa = 0.286, P = 0.039). The results determined by SMI and PG-SGA were consistent (P = 0.727), but the consistence was poor (Kappa = 0.399, P = 0.006). Conclusion:Human body composition analysis can identify the patients with muscular mass reduction that cannot be identified by commonly used nutrition assessment scales/parameters. Thus, it is helpful for the assessment of disease severity and also important for the nutrition assessment in CD patients.

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“…Chen et al diagnosed 11.8% of 313 gastric cancer patients with postlaparoscopic gastrectomy as sarcopenic [28]. Sarcopenia signi cantly increased the postoperative complications, hospital stay days, and total nancial costs of the patients with sarcopenia compared with the patients without it [26,29].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Sarcopenia and Its Effect on Postoperative Complications in Patients With Crohn’s Disease

Zhang

Hong

et al. 2021

Preprint

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Background and Aims: Sarcopenia is a prognostic factor of outcomes for various diseases, but reports on sarcopenia in patients with Crohn’s disease (CD) are few. We aim to determine the prevalence of sarcopenia and assess the role of sarcopenia in postoperative complications in patients with CD at a tertiary referral center.Methods: Patients who underwent intestinal surgery for CD from January 2013 to October 2019 were retrospectively enrolled. The L3 skeletal muscle mass index (SMI) was used to identify sarcopenia. Demographic data, preoperative laboratory data, surgical details, and hospital outcomes were recorded. The factors associated with postoperative complications were evaluated through univariate and multivariate analyses.Results: One hundred and twenty-four patients were enrolled. Thirty-four of them (27.4%), including 11 males, were diagnosed with sarcopenia. Compared with patients without sarcopenia, sarcopenic patients had a significantly lower BMI (P<0.001); lower preoperative serum albumin (P=0.006), pro-albumin (P=0.030), and hemoglobin levels (P<0.001); longer hospital stay (34.4±26.8 days vs. 22.8±15.6 days, P=0.003); and more occurrences of complications (41.2% vs. 23.3%, P=0.049). The overall incidence of postoperative complications was 28.2%. Infection (51.4%) and intestinal fistula (22.9%) were the most common among such complications. Through the multivariate analysis, sarcopenia was identified as an independent risk factor for major postoperative complications (odds ratio=3.974, 95% CI=1.171–13.489, P=0.027).Conclusion: Sarcopenia is common in patients with CD requiring bowel resection, and it significantly increases the risk of major postoperative complications.

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Sarcopenia as an independent predictor of the surgical outcomes of patients with inflammatory bowel disease: a meta-analysis

Cited by 53 publications

References 45 publications

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

Sarcopenia in Inflammatory Bowel Disease: A Narrative Overview

Role of Human Body Composition Analysis and Malnutrition Risk Questionnaire in the Assessment of Nutritional Status of Patients With Initially Diagnosed Crohn's Disease

Prevalence of Sarcopenia and Its Effect on Postoperative Complications in Patients With Crohn’s Disease

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