Monowar Hossain, Aged and Extended Care Services, The Queen Elizabeth Hospital. Central Adelaide Local Health Network, South Australia,
J Frailty Aging. 2021;10(1):63-69. doi: 10.14283/jfa.2020.27.
Sarcopenia is associated with adverse outcomes in cancer, chemotherapy, solid organ transplants, intensive care and medical patients. It has also been proven to increase perioperative mortality, hospital length of stay and complications in patients of various age groups. However, a limited number of studies have examined the association of post-surgical outcomes and sarcopenia inclusively in patients aged 65 years and older.
This scoping review aimed to examine the relationship between adverse post-surgical outcomes and sarcopenia in patients aged 65 years and older.
EMBASE and Medline databases were searched for sarcopenia, perioperative period and post-surgical outcomes. The articles were screened based on exclusion and inclusion criteria and were reviewed systematically as per the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews.
After duplicates removal and application of the inclusion and exclusion criteria, eight articles were included for this study from a total of nine hundred initially identified articles. All studies defined sarcopenia as low muscle mass but did not include physical function or muscle strength as the parameter of sarcopenia. Low muscle mass was associated with higher mortality in emergency surgeries, reduced long term survival in open elective surgeries, and increased length of hospital stay in endoscopic surgeries.
The current review suggests that low muscle mass is associated with higher mortality and various adverse post-surgical outcomes in the elderly. It remains to be determined if applying the definition of sarcopenia as per the international consensus/guidelines will affect the association of adverse post-surgical outcomes and sarcopenia.
肌肉减少症与癌症、化疗、实体器官移植、重症监护和内科患者的不良结局相关。它还被证明会增加各种年龄段患者的围手术期死亡率、住院时间和并发症。然而，只有少数研究检查了包括 65 岁及以上患者在内的术后结局和肌肉减少症之间的关联。
本次范围综述旨在检查 65 岁及以上患者不良术后结局与肌肉减少症之间的关系。
在 EMBASE 和 Medline 数据库中搜索肌肉减少症、围手术期和术后结局相关的文章。根据排除和纳入标准筛选文章，并按照乔安娜·布里格斯研究所（JBI）的综述方法进行系统审查。
在去除重复项并应用纳入和排除标准后，从最初确定的 900 篇文章中，有 8 篇文章纳入本研究。所有研究均将肌肉减少症定义为低肌肉量，但并未将身体功能或肌肉力量作为肌肉减少症的参数。低肌肉量与急诊手术中的高死亡率、择期开放手术中的长期生存率降低以及内镜手术中的住院时间延长相关。
目前的综述表明，低肌肉量与老年人更高的死亡率和各种不良术后结局相关。是否按照国际共识/指南定义肌肉减少症会影响不良术后结局和肌肉减少症之间的关联，仍有待确定。
