Sarcopenia defined by the psoas muscle mass or quality is associated with poor survival in patients with aortic aneurysm undergoing surgery: A meta-analysis

Dong, Geng; Wu, Xinyue; Wang, Yuxin; Jiang, He; Hu, Xueqi

doi:10.1016/j.arr.2023.101964

Cited by 7 publications

(2 citation statements)

References 38 publications

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“…This meta-analysis was limited to studies including EVAR patients because, to date, no meta-analysis has specifically studied the impact of frailty and sarcopenia on EVAR patients. Numerous studies have already shown the prognostic value of frailty and sarcopenia on the survival of patients with open AAA repair, or in series, including open repair of AAA and EVAR but without specifying the influence of frailty and sarcopenia in each of these groups analyzed separately [8,22,[31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Impact of Frailty and Sarcopenia on Thirty-Day and Long-Term Mortality in Patients Undergoing Elective Endovascular Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Saucy,

Probst,

Hungerbühler

et al. 2024

JCM

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Background: The aim of this study was to assess the prognostic role of frailty and sarcopenia on the survival of patients with AAA undergoing elective endovascular repair (EVAR). Methods: A systematic review of the literature was conducted in accordance with Meta-analysis of Observational Studies in Epidemiology (MOOSE). The association of frailty or sarcopenia with 30-day mortality and late survival was expressed as odds ratios (ORs) or hazard ratios (HRs) with a 95% confidence interval (CI). Meta-analysis random effects models were applied. The five-factor modified frailty index (mFI-5) was used as a frailty metric and sarcopenia was determined using computed tomography angiography (CTA) with measurements of the total psoas muscle area. Frailty was defined as patients with mFI-5 ≥ 0.6 and sarcopenia was defined as the total psoas muscle area (TPA) within the lowest tertile. Results: Thirteen observational cohorts reporting a total of 56,756 patient records were eligible for analysis. Patients with frailty (mFI-5 ≥ 0.6) had significantly increased 30-day mortality than those without frailty (random effects method: OR, 4.84, 95% CI 3.34–7.00, p < 0.001). Patients with sarcopenia (lowest TPA tertile) had significantly increased 30-day mortality according to the fixed effects method (OR, 3.30, 95% CI 2.17–5.02, p < 0.001), but not the random effects method (OR, 2.64, 95% CI 0.83–8.39, p = 0.098). Patients with sarcopenia or frailty had a significantly increased hazard ratio (HR) for late mortality than those without frailty or sarcopenia according to the random effects method (HR, 2.39, 95% CI 1.66–3.43, p < 0.001). The heterogeneity of the studies was low (I2: 0.00%, p = 0.86). The relation of frailty to age extracted from four studies demonstrates that the risk of frailty increases with age according to the random effects method (standard mean differences, SMD, 0.52, 95% CI 0.44–0.61, p < 0.001). The heterogeneity of the studies was low (I2: 0.00%, p = 0.64). Conclusions: Patients with sarcopenia or frailty have a significantly increased risk of mortality following elective EVAR. Prospective studies validating the use of frailty and sarcopenia for risk prediction after EVAR are needed before these tools can be used to support decision making.

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Section: Discussionmentioning

confidence: 99%

Impact of Frailty and Sarcopenia on Thirty-Day and Long-Term Mortality in Patients Undergoing Elective Endovascular Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Saucy,

Probst,

Hungerbühler

et al. 2024

JCM

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“…Some studies used the psoas muscle area or psoas muscle index to diagnose sarcopenia. Although psoas muscle has been recognized and recommended by some studies to diagnose sarcopenia ( 51 – 54 ), some literature has questioned this ( 55 – 57 ), and EWSOP2 still considers psoas as a small muscle, which may not reflect the state of the whole muscle ( 11 ). It is recommended to use the skeletal muscle index of the total lumbar muscle area (at the level of the third lumbar vertebra) to diagnose sarcopenia ( 58 ).…”

Section: Discussionmentioning

confidence: 99%

Ct-based diagnosis of sarcopenia as a prognostic factor for postoperative mortality after elective open-heart surgery in older patients: a cohort-based systematic review and meta-analysis

Yang,

Ji,

Deng

et al. 2024

Front. Public Health

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BackgroundCardiac open-heart surgery, which usually involves thoracotomy and cardiopulmonary bypass, is associated with a high incidence of postoperative mortality and adverse events. In recent years, sarcopenia, as a common condition in older patients, has been associated with an increased incidence of adverse prognosis.MethodsWe conducted a search of databases including PubMed, Embase, and Cochrane, with the search date up to January 1, 2024, to identify all studies related to elective cardiac open-heart surgery in older patients. We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence.ResultsA total of 12 cohort studies were included in this meta-analysis for analysis. This meta-analysis revealed that patients with sarcopenia had a higher risk of postoperative mortality. Furthermore, the total length of hospital stay and ICU stay were longer after surgery. Moreover, there was a higher number of patients requiring further healthcare after discharge. Regarding postoperative complications, sarcopenia patients had an increased risk of developing renal failure and stroke.ConclusionSarcopenia served as a tool to identify high-risk older patients undergoing elective cardiac open-heart surgery. By identifying this risk factor early on, healthcare professionals took targeted steps to improve perioperative function and made informed clinical decisions.Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023426026.

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Association of magnetic resonance imaging–derived sarcopenia with outcomes of patients with hepatocellular carcinoma after hepatectomy

Rao,

Chen,

et al. 2024

Abdom Radiol

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Sarcopenia defined by the psoas muscle mass or quality is associated with poor survival in patients with aortic aneurysm undergoing surgery: A meta-analysis

Cited by 7 publications

References 38 publications

Impact of Frailty and Sarcopenia on Thirty-Day and Long-Term Mortality in Patients Undergoing Elective Endovascular Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Impact of Frailty and Sarcopenia on Thirty-Day and Long-Term Mortality in Patients Undergoing Elective Endovascular Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis

Ct-based diagnosis of sarcopenia as a prognostic factor for postoperative mortality after elective open-heart surgery in older patients: a cohort-based systematic review and meta-analysis

Association of magnetic resonance imaging–derived sarcopenia with outcomes of patients with hepatocellular carcinoma after hepatectomy

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