Summary of current research on pediatric surgical patients with sarcopenia
| Reference | Population | Study design | Sample size (n) | Age (yr) | Methodology or modality | Indicators of muscle mass | Indicators of muscle strength or function | Definition of sarcopenia | Clinical outcome |
|---|---|---|---|---|---|---|---|---|---|
| Dedhia et al., 2018 [17] | Pediatric patients with UC undergoing colectomy | Retrospective | 29 | Range: 13–18 | MRI L3 |
PSMA and PMA | None | Lowest tertile of PSMA | 62% of patients with post colectomy complications with ulcerative colitis have significantly reduced PSMA |
| López et al., 2017 [30] | Pediatric patients with perforated appendicitis | Retrospective | 36 | Median: 11 | CT (pre and post op), L3 |
PMA | None | Mean percentage change in PMA index (PMA/height2) | N/A (Pediatric patients with complex appendicitis experience sarcopenic changes during hospital admission) |
| Mager et al., 2018 [19] | Pediatric post-LT patients | Retrospective | 41 | Range: 0.5–17 | DXA | SMM-z | None | SMM-z <–2SD of age and gender normative values | Sarcopenia was significantly associated with increased hospitalization and ventilator dependency |
| Oh et al., 2019 [26] | Pediatric patients undergoing the Fontan operation | Retrospective | 74 | Range: 2.8–3.3 | CT (pre and post op) |
Bilateral pectoralis muscles (T2) and erector spinae muscles (T12) | None | None | Preoperative low muscle mass was associated with poor early postoperative outcomes in pediatric patients undergoing the Fontan operation |
| Takeda et al., 2021 [25] | Children with LTfor biliary atresia | Retrospective | 89 | Range: 0.6–0.7 | CT (pre and post op) L3 and L4 |
PMA | None | tPMA-z<–2 | Sarcopenia in infants with BA may be associated with patient survival and serve as an effective marker for post-operative outcomes of LT |
| Ritz et al., 2021 [15] | Children with hepato-blastoma | Retrospective | 33 | Range: 1.2–3.0 | CT and MRI L3–L4 and L4–L5 |
PMA | None | tPMA-z<–2 | Sarcopenia was an additional risk factor for relapse in children with high-risk HB |
| Raghu et al., 2022 [27] | Pediatric intestinal transplant recipient | Retrospective | 56 | Range: 1.8–9.8 | CT L3–L4 and L4–L5 |
PMA | None | tPMA-z<–2 | N/A (Sarcopenia was not associated with decreased graft survival) |
| Muñoz-Serrano et al., 2023 [28] | Children with hepato-blastoma | Retrospective | 21 | Median: 3 | MRI | PMA | None | tPMA-z<–2 | N/A (Sarcopenia at diagnosis was associated with higher rates of metastases and surgical complications) |
| Jang et al., 2023 [29] | Pediatric patients undergoing total correction of TOF | Retrospective | 330 | Mean: 5 | Chest CT(pre and post op) | Bilateral pectoralis muscles (T2) and erector spinae muscles (T12) | None | MMI-z<–2 | N/A (Preoperative sarcopenia did not predict early postoperative major adverse events) |
UC = ulcerative colitis; LT = liver transplantation; TOF = tetralogy of Fallot; MRI = magnetic resonance imaging; CT = computed tomography; op = operative; DXA = dual-energy X-ray absorptiometry; PSMA = paraspinous muscle area; PMA = psoas muscle area; SMM-z = skeletal muscle mass z-score; SD = standard deviation; tPMA-z = total psoas muscle area z-score; N/A = not assessed; BA = biliary atresia; HB = hepatoblastoma.