Effect of low skeletal muscle mass on long-term mortality after abdominal aortic aneurysm repair: A meta-analysis.

Abstract

<h4>Objective</h4>This meta-analysis was designed to assess if pre-operative low skeletal muscle mass impacts mortality rates of patients undergoing abdominal aortic aneurysm (AAA) repair.<h4>Methods</h4>Datasets of PubMed, CENTRAL, ScienceDirect, Embase, and Google Scholar were searched from 1^st January 1980 to 15^th December 2021 for studies assessing the role of low skeletal muscle mass on mortality rates of AAA repair. Studies measuring skeletal muscle mass on computed tomography scans and reporting long-term mortality (>1 year) were included. Multivariable adjusted ratios were combined in a random-effects model.<h4>Results</h4>Fifteen studies with 3776 patients were included. Meta-analysis showed a statistically significant increased risk of all-cause mortality in patients with low skeletal muscle mass (HR: 2.07 95% CI: 1.56, 2.74 I2=65% p<0.00001) as compared to normal muscle mass patients. Pooled data indicated that low skeletal muscle mass was associated with statistically significant increased risk of mortality in studies on endovascular repair (HR: 2.86 95% CI: 1.95, 4.20 I2=58% p<0.00001) as well as those including a mixed group of patients (HR: 1.39 95% CI: 1.06, 1.82 I2=31% p=0.02).<h4>Conclusion</h4>Low skeletal muscle mass in AAA patients undergoing surgical repair is associated with increased risk of long-term mortality. Current evidence is limited by the retrospective nature of data and variability in defining and measuring low skeletal muscle mass. There is a need for future prospective studies defining the optimal cut-off of low skeletal muscle mass in different populations.