Abstract
Sarcopenia is the age-related loss of skeletal muscle mass, accompanied by reduced muscle strength or physical function. As the global population continues to age, the prevalence of sarcopenia is gradually increasing. It is conceivable that an increasing number of patients with sarcopenia will be scheduled for surgery and anesthesia in the near future. The complex pathogenesis and clinical features of sarcopenia have brought huge challenges to perioperative management, especially in clinical anesthesia. However, there are currently neither guidelines nor expert consensus on the perioperative management of patients with sarcopenia. In this review, we summarize and elaborate on the pathogenesis, diagnosis, and perioperative precautions of sarcopenia, thereby providing information on the perioperative and anesthestic management of patients with sarcopenia.
Highlights
As the average life expectancy increases, the prevalence of sarcopenia was gradually increased
Studies have shown that the pathophysiological changes caused by sarcopenia and aging can significantly increase the risk of perioperative adverse events, including adverse cardiovascular events, adverse drug reactions, severe postoperative complications, prolongation of hospital stay, surgical failure, and even high mortality [14,15,16]
We comprehensively evaluate muscle strength, physical function, and muscle mass in order to make a correct diagnosis for elderly patients according to an algorithm (Fig. 1)
Summary
There are strong correlations between sarcopenia and falls, disability, adverse outcomes, and mortality in the elderly, so the early diagnosis of sarcopenia is important [17]. We comprehensively evaluate muscle strength, physical function, and muscle mass in order to make a correct diagnosis for elderly patients according to an algorithm (Fig. 1). CT and MRI are the gold standards for assessing muscle mass, they are relatively expensive and lack precise diagnostic cut-offs; they are not commonly used in clinical practice [18]. DXA and BIA are inexpensive, safe, and convenient, so the European Working Group on Sarcopenia in Older People (EWGSOP) and AWGS recommend the use of DXA or BIA for muscle mass determination and provide diagnostic cut-offs [2, 3]. The effectiveness of ultrasounds in measuring muscle mass has been proven, the EWGSOP does not recommend using an ultrasound as a diagnostic tool due to the lack of standardized measurement methods and prediction equations [2, 20]. Due to the lack of diagnostic criteria, these are still not widely evaluated in clinical practice
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