Key result
Preoperative sarcopenia linked to ~210% higher in-hospital mortality risk after elective open-heart surgery.
Why the study?
Cardiac open-heart surgery carries high postoperative mortality and adverse events, and sarcopenia has been increasingly linked to adverse prognosis in older patients.
Does preoperative CT-based diagnosis of sarcopenia predict increased in-hospital mortality and adverse outcomes in older patients undergoing elective cardiac open-heart surgery?
Meta-Analysis (n=4,749)
Does preoperative CT-based diagnosis of sarcopenia predict increased in-hospital mortality and adverse outcomes in older patients undergoing elective cardiac open-heart surgery?
Effect estimate: OR 3.10 (95% CI 1.80-5.34)
p-value: p=<0.0001
Preoperative CT-based diagnosis of sarcopenia identifies older patients at significantly higher risk for in-hospital mortality, prolonged hospital stays, and postoperative complications following elective open-heart surgery.
May inform preoperative risk stratification before elective open-heart surgery; leaves open whether interventions improve outcomes.
Background 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. Methods 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. Results 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. Conclusion 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. Systematic review registration : https://www.crd.york.ac.uk/prospero/ , identifier CRD42023426026.
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Yang et al. (2024) conducted a meta-analysis in Elective cardiac open-heart surgery in older patients (n=4,749). Sarcopenia (CT-based diagnosis) vs. Non-sarcopenia was evaluated on In-hospital mortality (OR 3.10, 95% CI 1.80-5.34, p=<0.0001). Preoperative CT-diagnosed sarcopenia significantly increased the risk of in-hospital mortality (OR 3.10) compared to non-sarcopenia in older patients undergoing elective open-heart surgery.
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