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

• Published in: Frontiers in public health 2024-07, Vol.12, p.1378462
• Main Authors: Yang, Tao-Ran, Ji, Peng, Deng, Xiao, Feng, Xi-Xia, He, Meng-Lin, Wang, Ru-Rong, Li, Xue-Han
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; cardiac surgery; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Elective Surgical Procedures - adverse effects; Humans; Length of Stay; older patients; Postoperative Complications - mortality; Prognosis; Public Health; Risk Factors; sarcopenia; Sarcopenia - diagnostic imaging; skeletal muscle index; Tomography, X-Ray Computed
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2024.1378462

Cardiac 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. We 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. A 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. Sarcopenia 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. : https://www.crd.york.ac.uk/prospero/, identifier CRD42023426026.