Shahab Hajibandeh1, Shahin Hajibandeh2, Ross Jarvis3, Talvinder Bhogal4, Sanjush Dalmia5. 1. Department of General Surgery, North Manchester General Hospital, Manchester, UK. Electronic address: shahab_hajibandeh@yahoo.com. 2. Department of General Surgery, Stepping Hill Hospital, Stockport, UK. 3. Department of General Surgery, Royal Bolton Hospital, Bolton, UK. 4. Department of General Surgery, Salford Royal Foundation Trust, Salford, UK. 5. Department of General Surgery, North Manchester General Hospital, Manchester, UK; Bury Grammar School Boys, Bury, UK.
Abstract
OBJECTIVES: To investigate the effect of sarcopenia on postoperative mortality in patients undergoing emergency abdominal procedures and to compare postoperative mortality in patients with sarcopenia undergoing emergency abdominal procedures with those undergoing elective abdominal procedures. METHODS: A search of electronic information sources was conducted to identify all observational studies comparing sarcopenia with no sarcopenia in a) emergency abdominal surgery and b) elective abdominal surgery. We also identified the available cohort of patients in the literature with sarcopenia undergoing abdominal procedures and divided the entire cohort into two groups based on exposure to emergency surgery or elective surgery. The primary outcome measure of this study was postoperative 30-day mortality. RESULTS: Overall, 4 studies, enrolling a total of 734 patients, were eligible for the comparison in emergency setting and 16 studies, enrolling a total of 4590 patients, were eligible for the comparison in elective setting. Sarcopenia is associated with significantly higher risk of 30-day mortality (RR: 2.15, P < 0.0001), 1-year mortality (RR:1.97, P < 0.0001), total complications (RR:2.07, P = 0.0008), and need for ICU admission (RR:1.38, P = 0.003) and significantly longer length of ICU stay (MD:2.26, P = 0.006) and length of hospital stay (MD:2.46, P < 0.00001) compared to no sarcopenia in patients undergoing emergency abdominal procedures. Sarcopenia was also associated with significantly higher risk of 30-day mortality in patients undergoing elective abdominal procedures (RR:2.15, P = 0.002). Emergency abdominal surgery in patients with sarcopenia was associated with significantly higher risk of 30-day mortality compared to elective surgery (OR:12.00, P < 0.00001). CONCLUSIONS: Sarcopenia is an independent predictor of postoperative mortality in emergency abdominal surgery.
OBJECTIVES: To investigate the effect of sarcopenia on postoperative mortality in patients undergoing emergency abdominal procedures and to compare postoperative mortality in patients with sarcopenia undergoing emergency abdominal procedures with those undergoing elective abdominal procedures. METHODS: A search of electronic information sources was conducted to identify all observational studies comparing sarcopenia with no sarcopenia in a) emergency abdominal surgery and b) elective abdominal surgery. We also identified the available cohort of patients in the literature with sarcopenia undergoing abdominal procedures and divided the entire cohort into two groups based on exposure to emergency surgery or elective surgery. The primary outcome measure of this study was postoperative 30-day mortality. RESULTS: Overall, 4 studies, enrolling a total of 734 patients, were eligible for the comparison in emergency setting and 16 studies, enrolling a total of 4590 patients, were eligible for the comparison in elective setting. Sarcopenia is associated with significantly higher risk of 30-day mortality (RR: 2.15, P < 0.0001), 1-year mortality (RR:1.97, P < 0.0001), total complications (RR:2.07, P = 0.0008), and need for ICU admission (RR:1.38, P = 0.003) and significantly longer length of ICU stay (MD:2.26, P = 0.006) and length of hospital stay (MD:2.46, P < 0.00001) compared to no sarcopenia in patients undergoing emergency abdominal procedures. Sarcopenia was also associated with significantly higher risk of 30-day mortality in patients undergoing elective abdominal procedures (RR:2.15, P = 0.002). Emergency abdominal surgery in patients with sarcopenia was associated with significantly higher risk of 30-day mortality compared to elective surgery (OR:12.00, P < 0.00001). CONCLUSIONS:Sarcopenia is an independent predictor of postoperative mortality in emergency abdominal surgery.