Sarcopenia and risk of postoperative pneumonia: a systematic review and meta-analysis.

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY Journal of Nutrition Health & Aging Pub Date : 2024-12-23 DOI:10.1016/j.jnha.2024.100457

Xiaoyu Shu, Quhong Song, Xiaoli Huang, Tianjiao Tang, Li Huang, Yanli Zhao, Taiping Lin, Ping Xu, Pingjing Yu, Jirong Yue

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Abstract

Background: Identifying patients at risk for postoperative pneumonia and preventing it in advance is crucial for improving the prognoses of patients undergoing surgery. This review aimed to interpret the predictive value of sarcopenia on postoperative pneumonia.

Methods: Science Citation Index Expanded (SCIE), Embase, Medline, and Cochrane Central Register of Controlled Trials were searched from inception to August 2nd, 2023 to retrieve eligible studies. The risk of bias was assessed by the Newcastle-Ottawa Scale (NOS). For each study, we computed the odds ratio (OR) and 95% confidence interval (CI) for postoperative pneumonia in patients with and without preoperative sarcopenia, and the I-squared (I²) test was employed to estimate heterogeneity.

Results: The search identified 6530 studies, and 32 studies including 114,532 participants were analyzed in this review. In most of the studies included, the risk of bias was moderate. The most reported surgical site was the chest and abdomen, followed by the abdomen, chest, limbs and spine, and head and neck. Overall, patients with preoperative sarcopenia have a 2.62-fold increased risk of developing postoperative pneumonia compared to non-sarcopenic patients [OR 2.62 (I² = 67.5%, 95%CI 2.04-3.37). Subgroup analysis focusing on different surgical sites revealed that sarcopenia has the strongest predictive effect on postoperative pneumonia following abdominal surgery (OR 4.69, I² = 0, 95% CI 3.06-7.19). Subgroup analyses targeting different types of research revealed that sarcopenia has a stronger predictive effect on postoperative pneumonia in prospective studies (OR 5.84 vs. 2.22).

Conclusions: Our research findings indicate that preoperative sarcopenia significantly increases the risk of postoperative pneumonia. Future high-quality prospective studies and intervention studies are needed to validate the relationship between sarcopenia and postoperative pneumonia and improve patient outcomes.

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肌肉减少症与术后肺炎的风险：一项系统回顾和荟萃分析。

背景：识别有术后肺炎风险的患者并提前预防，对于改善手术患者的预后至关重要。本综述旨在解释肌肉减少症对术后肺炎的预测价值。方法：检索科学引文索引扩展（SCIE）、Embase、Medline和Cochrane中央对照试验注册库（Central Register of Controlled Trials），检索自成立至2023年8月2日的符合条件的研究。偏倚风险采用纽卡斯尔-渥太华量表（NOS）进行评估。对于每项研究，我们计算了伴有和不伴有术前肌肉减少症患者术后肺炎的比值比（OR）和95%置信区间（CI），并采用i平方（I2）检验来估计异质性。结果：本综述共纳入了6530项研究，分析了32项研究，包括114532名受试者。在大多数纳入的研究中，偏倚的风险是中等的。报道最多的手术部位是胸部和腹部，其次是腹部、胸部、四肢和脊柱以及头颈部。总体而言，术前肌肉减少患者术后发生肺炎的风险是非肌肉减少患者的2.62倍[OR 2.62 (I2 = 67.5%, 95%CI 2.04-3.37)]。针对不同手术部位的亚组分析显示，肌肉减少症对腹部手术后肺炎的预测作用最强（OR 4.69, I2 = 0, 95% CI 3.06-7.19）。针对不同类型研究的亚组分析显示，在前瞻性研究中，肌肉减少症对术后肺炎有更强的预测作用（OR 5.84 vs. 2.22）。结论：我们的研究结果表明，术前肌肉减少明显增加术后肺炎的风险。未来需要高质量的前瞻性研究和干预研究来验证肌肉减少症与术后肺炎之间的关系，并改善患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.