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BMC Geriatr. 2017 Aug 21;17(1):188. doi: 10.1186/s12877-017-0569-2.

The impact of frailty and sarcopenia on postoperative outcomes in older patients undergoing gastrectomy surgery: a systematic review and meta-analysis.

Shen Y1,2,3, Hao Q1,3, Zhou J3, Dong B4,5.

Author information

1
The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, #37 Guoxuexiang, Chengdu, Sichuan, 610041, China.
2
The First Affiliated Hospital Medical College, Chengdu Medical College, No. 278 Middle of Baoguang Road, Xindu District, Chengdu, Sichuan, 610500, China.
3
Collaborative Innovation Center of Sichuan for Elderly Care and Health, No. 783, Xindu Lu, Chengdu, Sichuan, 610500, China.
4
The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, #37 Guoxuexiang, Chengdu, Sichuan, 610041, China. birongdong123@outlook.com.
5
Collaborative Innovation Center of Sichuan for Elderly Care and Health, No. 783, Xindu Lu, Chengdu, Sichuan, 610500, China. birongdong123@outlook.com.

Abstract

BACKGROUND:

Gastric cancer is a major health problem, and frailty and sarcopenia will affect the postoperative outcomes in older people. However, there is still no systematic review to determine the role of frailty and sarcopenia in predicting postoperative outcomes among older patients with gastric cancer who undergo gastrectomy surgery.

METHODS:

We searched Embase, Medline through the Ovid interface and PubMed websites to identify potential studies. All the search strategies were run on August 24, 2016. We searched the Google website for unpublished studies on June 1, 2017. The data related to the endpoints of gastrectomy surgery were extracted. Odds ratios (ORs) and their 95% confidence intervals (CIs) were pooled to estimate the association between sarcopenia and adverse postoperative outcomes by using Stata version 11.0. PRISMA guidelines for systematic reviews were followed.

RESULTS:

After screening 500 records, we identified eight studies, including three prospective cohort studies and five retrospective cohort studies. Only one study described frailty, and the remaining seven studies described sarcopenia. Frailty was statistically significant for predicting hospital mortality (OR 3.96; 95% CI: 1.12-14.09, P = 0.03). Sarcopenia was also associated with postoperative outcomes (pooled OR 3.12; 95% CI: 2.23-4.37). No significant heterogeneity was observed across these pooled studies (Chi2 = 3.10, I2 = 0%, P = 0.685).

CONCLUSION:

Sarcopenia and frailty seem to have significant adverse impacts on the occurrence of postoperative outcomes. Well-designed prospective cohort studies focusing on frailty and quality of life with a sufficient sample are needed.

KEYWORDS:

Frailty; Gastric cancer; Postoperative complications; Sarcopenia

PMID:
28826406
PMCID:
PMC5563908
DOI:
10.1186/s12877-017-0569-2
[Indexed for MEDLINE]
Free PMC Article

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