The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang City, Hunan Province, China.
Department of Anorectal Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
PLoS One. 2024 Aug 26;19(8):e0302291. doi: 10.1371/journal.pone.0302291. eCollection 2024.
Sarcopenia is considered to be an important predictor of adverse outcomes following spinal surgery, but the specific relationship between the two is not clear. The purpose of this meta-analysis is to systematically review all relevant studies to evaluate the impact of sarcopenia on spinal surgery outcomes.
We systematically searched PubMed, Embase and the Cochrane Library for relevant articles published on or before January 9, 2023. The pooled odds ratio (OR) with 95% confidence intervals (CIs) was calculated in a random effects meta-analysis. The main outcome was the risk of adverse outcomes after spinal surgery, including adverse events and mortality. This systematic review and meta-analysis was conducted following the PRISMA guidelines to evaluate the impact of sarcopenia on spinal surgery outcomes. In addition, we also conducted a subgroup analysis and leave-one-out sensitivity analyses to explore the main sources of heterogeneity and the stability of the results.
Twenty-four cohort studies, with a total of 243,453 participants, met the inclusion criteria. The meta-analysis showed that sarcopenia was significantly associated with adverse events (OR 1.63, 95% CI 1.17-2.27, P < 0.001) but was no significantly associated with mortality (OR 1.17, 95% CI 0.93-1.46, P = 0.180), infection (OR 2.24, 95% CI 0.95-5.26, P < 0.001), 30-day reoperation (OR 1.47, 95% CI 0.92-2.36, P = 0.413), deep vein thrombosis (OR 1.78, 95% CI 0.69-4.61, P = 0.234), postoperative home discharge (OR 0.60, 95% CI 0.26-1.37, P = 0.002) and blood transfusion (OR 3.28, 95% CI 0.74-14.64, P = 0.015).
The current meta-analysis showed that patients with sarcopenia have an increased risk of adverse events and mortality after spinal surgery. However, these results must be carefully interpreted because the number of studies included is small and the studies are significantly different. These findings may help to increase the clinicians' awareness of the risks concerning patients with sarcopenia to improve their prognosis.
肌少症被认为是脊柱手术后不良结局的重要预测因素，但两者之间的具体关系尚不清楚。本荟萃分析的目的是系统地回顾所有相关研究，以评估肌少症对脊柱手术结局的影响。
我们系统地检索了 PubMed、Embase 和 Cochrane 图书馆中截至 2023 年 1 月 9 日发表的相关文章。采用随机效应荟萃分析计算合并的比值比（OR）及其 95%置信区间（CI）。主要结局是脊柱手术后不良结局的风险，包括不良事件和死亡率。本系统评价和荟萃分析遵循 PRISMA 指南，以评估肌少症对脊柱手术结局的影响。此外，我们还进行了亚组分析和逐一剔除敏感性分析，以探讨主要异质性来源和结果的稳定性。
24 项队列研究，共纳入 243453 名参与者，符合纳入标准。荟萃分析显示，肌少症与不良事件显著相关（OR 1.63，95%CI 1.17-2.27，P < 0.001），但与死亡率无显著相关性（OR 1.17，95%CI 0.93-1.46，P = 0.180）、感染（OR 2.24，95%CI 0.95-5.26，P < 0.001）、30 天再手术（OR 1.47，95%CI 0.92-2.36，P = 0.413）、深静脉血栓形成（OR 1.78，95%CI 0.69-4.61，P = 0.234）、术后家庭出院（OR 0.60，95%CI 0.26-1.37，P = 0.002）和输血（OR 3.28，95%CI 0.74-14.64，P = 0.015）。
本荟萃分析显示，肌少症患者脊柱手术后发生不良事件和死亡的风险增加。然而，由于纳入的研究数量较少，且研究之间存在显著差异，这些结果必须谨慎解释。这些发现可能有助于提高临床医生对肌少症患者相关风险的认识，从而改善其预后。
