Sex-specific impact of computed tomography-defined sarcopenia on postoperative complications following elective cardiac surgery in older patients.
- 1Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan.
- 2Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
- 3Department of Health Policy and Management, Nippon Medical School, Tokyo, Japan.
Abstract
Objectives
Sex-specific differences in sarcopenia-related prognosis after cardiac surgery are unclear. We aimed to investigate the association between preoperative computed tomography-defined sarcopenia and postoperative complications in older patients undergoing elective cardiac surgeries, focusing on sex-specific differences.Methods
This retrospective observational study included 133 patients aged 65 years or more who underwent elective open surgeries. Sarcopenia was assessed using the psoas muscle area index derived from preoperative computed tomography scans and defined using sex-specific cutoff values. The primary outcome was postoperative complication.Results
Forty-nine patients (36.8%) had sarcopenia. Although the incidence of complications was higher in this group, the difference was not statistically significant between the groups. Multivariate logistic regression analysis excluding patients with preexisting atrial fibrillation revealed that sarcopenia was independently associated with a higher risk of postoperative complications (odds ratio, 3.73, 95% CI, 1.49-9.84, P = .006). The male patients with sarcopenia showed a higher incidence of complications versus those without (56.8% vs 33.9%, P = .046), whereas no association was observed in the female patients. Sex-stratified analyses confirmed the independent prognostic value of sarcopenia in male patients only (odds ratio, 2.52, 95% CI, 1.08-6.01, P = .033).Conclusions
Preoperative computed tomography-defined sarcopenia was independently associated with postoperative complications in older male patients undergoing elective cardiac surgeries, but not in female patients. These findings suggest that the prognostic significance of sarcopenia is sex-specific and highlight the importance of sex-specific risk stratification strategies in older patient populations undergoing cardiac surgeries.
Related
- Postoperative complications and care requirements following Achilles tendon repair : A retrospective cohort study
- Serum procalcitonin as an early marker associated with postoperative complications following liver resection: A prospective observational study
- Association of a multimodal perioperative nutritional/ERAS care pathway with postoperative infectious complications following radical hysterectomy for cervical cancer: a retrospective nonconcurrent cohort study
- Risk factors and outcomes of early postoperative complications following congenital heart surgery: a retrospective study at a tertiary care hospital in Nairobi, Kenya.
- Changing sarcopenia diagnostic criteria from AWGS2019 to 2025 impacts prevalence and postoperative risk prediction
BibTeX
@article{ueda2026sexspecific,
title = {{Sex-specific impact of computed tomography-defined sarcopenia on postoperative complications following elective cardiac surgery in older patients.}},
author = {Hitomi Ueda and Yoshiaki Kubota and Yuji Maruyama and Takuya Nishino and Kuniya Asai and Yosuke Ishii},
journal = {JTCVS open},
year = {2026},
month = jul,
doi = {10.1016/j.xjon.2026.101975},
url = {https://europepmc.org/article/MED/42948417},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sex-specific impact of computed tomography-defined sarcopenia on postoperative complications following elective cardiac surgery in older patients.
AU - Hitomi Ueda
AU - Yoshiaki Kubota
AU - Yuji Maruyama
AU - Takuya Nishino
AU - Kuniya Asai
AU - Yosuke Ishii
PY - 2026
DA - 2026/07/27
JO - JTCVS open
DO - 10.1016/j.xjon.2026.101975
UR - https://europepmc.org/article/MED/42948417
AB - Objectives Sex-specific differences in sarcopenia-related prognosis after cardiac surgery are unclear. We aimed to investigate the association between preoperative computed tomography-defined sarcopenia and postoperative complications in older patients undergoing elective cardiac surgeries, focusing on sex-specific differences.Methods This retrospective observational study included 133 patients aged 65 years or more who underwent elective open surgeries. Sarcopenia was assessed using the psoas muscle area index derived from preoperative computed tomography scans and defined using sex-specific cutoff values. The primary outcome was postoperative complication.Results Forty-nine patients (36.8%) had sarcopenia. Although the incidence of complications was higher in this group, the difference was not statistically significant between the groups. Multivariate logistic regression analysis excluding patients with preexisting atrial fibrillation revealed that sarcopenia was independently associated with a higher risk of postoperative complications (odds ratio, 3.73, 95% CI, 1.49-9.84, P = .006). The male patients with sarcopenia showed a higher incidence of complications versus those without (56.8% vs 33.9%, P = .046), whereas no association was observed in the female patients. Sex-stratified analyses confirmed the independent prognostic value of sarcopenia in male patients only (odds ratio, 2.52, 95% CI, 1.08-6.01, P = .033).Conclusions Preoperative computed tomography-defined sarcopenia was independently associated with postoperative complications in older male patients undergoing elective cardiac surgeries, but not in female patients. These findings suggest that the prognostic significance of sarcopenia is sex-specific and highlight the importance of sex-specific risk stratification strategies in older patient populations undergoing cardiac surgeries.
SN - 2666-2736
ER -