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Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis

BACKGROUND: The evidence of sarcopenia based on CT-scan as an important prognostic factor for critically ill patients has not seen consistent results. To determine the impact of sarcopenia on mortality in critically ill patients, we performed a systematic review and meta-analysis to quantify the ass...

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Autores principales: Zhang, Xiao-Ming, Chen, Denghong, Xie, Xiao-Hua, Zhang, Jun-E, Zeng, Yingchun, Cheng, Andy SK
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173733/
https://www.ncbi.nlm.nih.gov/pubmed/34078275
http://dx.doi.org/10.1186/s12877-021-02276-w
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author Zhang, Xiao-Ming
Chen, Denghong
Xie, Xiao-Hua
Zhang, Jun-E
Zeng, Yingchun
Cheng, Andy SK
author_facet Zhang, Xiao-Ming
Chen, Denghong
Xie, Xiao-Hua
Zhang, Jun-E
Zeng, Yingchun
Cheng, Andy SK
author_sort Zhang, Xiao-Ming
collection PubMed
description BACKGROUND: The evidence of sarcopenia based on CT-scan as an important prognostic factor for critically ill patients has not seen consistent results. To determine the impact of sarcopenia on mortality in critically ill patients, we performed a systematic review and meta-analysis to quantify the association between sarcopenia and mortality. METHODS: We searched studies from the literature of PubMed, EMBASE, and Cochrane Library from database inception to June 15, 2020. All observational studies exploring the relationship between sarcopenia based on CT-scan and mortality in critically ill patients were included. The search and data analysis were independently conducted by two investigators. A meta-analysis was performed using STATA Version 14.0 software using a fixed-effects model. RESULTS: Fourteen studies with a total of 3,249 participants were included in our meta-analysis. The pooled prevalence of sarcopenia among critically ill patients was 41 % (95 % CI:33-49 %). Critically ill patients with sarcopenia in the intensive care unit have an increased risk of mortality compared to critically ill patients without sarcopenia (OR = 2.28, 95 %CI: 1.83–2.83; P < 0.001; I(2) = 22.1 %). In addition, a subgroup analysis found that sarcopenia was associated with high risk of mortality when defining sarcopenia by total psoas muscle area (TPA, OR = 3.12,95 %CI:1.71–5.70), skeletal muscle index (SMI, OR = 2.16,95 %CI:1.60–2.90), skeletal muscle area (SMA, OR = 2.29, 95 %CI:1.37–3.83), and masseter muscle(OR = 2.08, 95 %CI:1.15–3.77). Furthermore, critically ill patients with sarcopenia have an increased risk of mortality regardless of mortality types such as in-hospital mortality (OR = 1.99, 95 %CI:1.45–2.73), 30-day mortality(OR = 2.08, 95 %CI:1.36–3.19), and 1-year mortality (OR = 3.23, 95 %CI:2.08 -5.00). CONCLUSIONS: Sarcopenia increases the risk of mortality in critical illness. Identifying the risk factors of sarcopenia should be routine in clinical assessments and offering corresponding interventions may help medical staff achieve good patient outcomes in ICU departments. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02276-w.
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spelling pubmed-81737332021-06-03 Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis Zhang, Xiao-Ming Chen, Denghong Xie, Xiao-Hua Zhang, Jun-E Zeng, Yingchun Cheng, Andy SK BMC Geriatr Research Article BACKGROUND: The evidence of sarcopenia based on CT-scan as an important prognostic factor for critically ill patients has not seen consistent results. To determine the impact of sarcopenia on mortality in critically ill patients, we performed a systematic review and meta-analysis to quantify the association between sarcopenia and mortality. METHODS: We searched studies from the literature of PubMed, EMBASE, and Cochrane Library from database inception to June 15, 2020. All observational studies exploring the relationship between sarcopenia based on CT-scan and mortality in critically ill patients were included. The search and data analysis were independently conducted by two investigators. A meta-analysis was performed using STATA Version 14.0 software using a fixed-effects model. RESULTS: Fourteen studies with a total of 3,249 participants were included in our meta-analysis. The pooled prevalence of sarcopenia among critically ill patients was 41 % (95 % CI:33-49 %). Critically ill patients with sarcopenia in the intensive care unit have an increased risk of mortality compared to critically ill patients without sarcopenia (OR = 2.28, 95 %CI: 1.83–2.83; P < 0.001; I(2) = 22.1 %). In addition, a subgroup analysis found that sarcopenia was associated with high risk of mortality when defining sarcopenia by total psoas muscle area (TPA, OR = 3.12,95 %CI:1.71–5.70), skeletal muscle index (SMI, OR = 2.16,95 %CI:1.60–2.90), skeletal muscle area (SMA, OR = 2.29, 95 %CI:1.37–3.83), and masseter muscle(OR = 2.08, 95 %CI:1.15–3.77). Furthermore, critically ill patients with sarcopenia have an increased risk of mortality regardless of mortality types such as in-hospital mortality (OR = 1.99, 95 %CI:1.45–2.73), 30-day mortality(OR = 2.08, 95 %CI:1.36–3.19), and 1-year mortality (OR = 3.23, 95 %CI:2.08 -5.00). CONCLUSIONS: Sarcopenia increases the risk of mortality in critical illness. Identifying the risk factors of sarcopenia should be routine in clinical assessments and offering corresponding interventions may help medical staff achieve good patient outcomes in ICU departments. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02276-w. BioMed Central 2021-06-02 /pmc/articles/PMC8173733/ /pubmed/34078275 http://dx.doi.org/10.1186/s12877-021-02276-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Zhang, Xiao-Ming
Chen, Denghong
Xie, Xiao-Hua
Zhang, Jun-E
Zeng, Yingchun
Cheng, Andy SK
Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
title Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
title_full Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
title_fullStr Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
title_full_unstemmed Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
title_short Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
title_sort sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173733/
https://www.ncbi.nlm.nih.gov/pubmed/34078275
http://dx.doi.org/10.1186/s12877-021-02276-w
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