Association of Sarcopenia With Global, Motor, Cognitive, and Swallowing Function Prognosis in Stroke Patients: A Systematic Review and Meta‐Analysis

OBJECTIVE: Sarcopenia has been demonstrated to correlate with the prognosis of stroke. This study aimed to systematically evaluate the impact of sarcopenia on global, motor, cognitive, and swallowing function outcomes in stroke patients. METHODS: Relevant studies investigating the association between sarcopenia and multidimensional prognostic outcomes in stroke were retrieved from the PubMed, Embase, Web of Science, Cochrane Library, and Scopus databases. The primary outcome was the risk of poor global functional prognosis assessed by the modified Rankin Scale (mRS). Secondary outcomes included motor function scores (Functional Independence Measure-motor, FIM-motor), cognitive function scores, and the risk of swallowing dysfunction. RESULTS: A total of 36 cohort studies were finally included. Pooled results indicated that stroke patients with comorbid sarcopenia faced a notably elevated risk of poor global functional prognosis (mRS, OR = 2.43, 95% CI: 1.95 to 3.03, p < 0.001). The motor function scores (FIM-motor, SMD = -0.94, 95% CI: -1.11 to -0.77, p < 0.001) and cognitive function scores (FIM-cognition or Montreal Cognitive Assessment, SMD = -0.95, 95% CI: -1.22 to -0.69, p < 0.001) in the sarcopenia group were significantly lower than those in the non-sarcopenia group, while the risk of swallowing dysfunction showed a notable but non-significant elevation (endotracheal intubation or Functional Oral Intake Scale, OR = 1.45, 95% CI: 0.94 to 2.25, p = 0.09). Subgroup analyses indicated that the patient populations, cut-off value of mRS, follow-up duration, stroke type, and diagnostic criteria for sarcopenia were the main sources of heterogeneity. Sensitivity analyses confirmed the robustness of the results. Egger's test suggested the presence of publication bias, but the conclusions remained valid after correction using the trim-and-fill method. CONCLUSION: Sarcopenia is an important risk factor for poor global, motor, cognitive, and swallowing function prognosis in stroke patients. In clinical practice, sarcopenia screening should be incorporated into the routine assessment of stroke patients, and individualized interventions should be promptly implemented for high-risk populations to improve long-term prognosis.