Sarcopenia and Mortality Risk of Patients with Sepsis: A Meta-Analysis

Abstract

Background. The association between sarcopenia at admission and mortality in patients with sepsis has not been comprehensively evaluated. We performed a meta-analysis to systematically evaluate the above association. Methods. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intrastudy heterogeneity was selected to pool the results. Subgroup analyses were applied to evaluate the influences of study characteristics on relationship. Results. Ten cohort studies including 2396 patients with sepsis were included, and 1496 (62.4%) of them had sarcopenia at presentation. Pooled results showed that compared to those without sarcopenia, septic patients with sarcopenia had a significantly increased early (in-hospital or 1-month) mortality risk (risk ration (RR): 2.14, 95% confidence interval (CI): 1.60–2.87, $P$  < 0.001; I2 = 46%). Subgroup analyses showed consistent association between sarcopenia and increased acute mortality risk in septic patients which were not affected by study characteristics such as study design, country of the study, clinical settings, diagnostic criteria for sepsis, age, gender of the patients, and methods for diagnosis of sarcopenia ( $P$ for all subgroup analyses >0.05). Further meta-analyses showed that sarcopenia was also associated with increased mortality risk in septic patients at 3–6 months (RR: 2.13, 95% CI: 1.58–2.89, $P$  < 0.001; I2 = 0%) and at 1 year (RR: 1.57, 95% CI: 1.09–2.24, $P$  = 0.01; I2 = 29%). Conclusions. Current evidence suggests that sarcopenia may be a predictor of mortality in patients with sepsis.