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, 17 (1), 188

The Impact of Frailty and Sarcopenia on Postoperative Outcomes in Older Patients Undergoing Gastrectomy Surgery: A Systematic Review and Meta-Analysis


The Impact of Frailty and Sarcopenia on Postoperative Outcomes in Older Patients Undergoing Gastrectomy Surgery: A Systematic Review and Meta-Analysis

Yanjiao Shen et al. BMC Geriatr.


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 We searched the Google website for unpublished studies on June 1, 2017.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.

Conflict of interest statement

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Not applicable.

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Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Fig. 1
Fig. 1
Flowchart of search results and study selection
Fig. 2
Fig. 2
Forest plot of the odds ratios for the association between sarcopenia and postoperative complications of gastric cancer
Fig. 3
Fig. 3
Funnel plot of sarcopenia and postoperative complications of gastric cancer

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