Sarcopenia as a predictor of mortality among the critically ill in an intensive care unit: a systematic review and meta-analysis
Autor: | Jun-e Zhang, Yingchun Zeng, Andy S. K. Cheng, Denghong Chen, Xiaohua Xie, Xiao-Ming Zhang |
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Rok vydání: | 2021 |
Předmět: |
Sarcopenia
medicine.medical_specialty Critical Illness medicine.medical_treatment Subgroup analysis Cochrane Library law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Risk of mortality Humans Medicine Intensive care unit Hospital Mortality 030212 general & internal medicine Mortality Muscle Skeletal Critically ill Rehabilitation business.industry RC952-954.6 030208 emergency & critical care medicine medicine.disease Intensive Care Units Meta-analysis Geriatrics Observational study Geriatrics and Gerontology business human activities Research Article |
Zdroj: | BMC Geriatrics, Vol 21, Iss 1, Pp 1-13 (2021) BMC Geriatrics |
ISSN: | 1471-2318 |
Popis: | 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 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. |
Databáze: | OpenAIRE |
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