Impact of Sarcopenia and Its Severity on Postoperative Functional Decline in Patients Undergoing Cardiac Surgery.

INTRODUCTION: In this study, we aimed to evaluate the impact of sarcopenia and its severity on postoperative functional decline in patients undergoing cardiac surgery. METHODS: This retrospective cohort study included 161 patients (median age, 71 years; 75.8% male) who underwent elective cardiac surgery at a tertiary care hospital between April 2021 and November 2024. Functional decline was assessed by subtracting the preoperative Barthel Index (BI) score from the score at discharge. Sarcopenia severity was assessed based on the Asian Working Group for Sarcopenia 2019 criteria. Multiple linear regression models adjusted for relevant clinical and demographic factors were used to examine the associations among sarcopenia, severe sarcopenia, and functional decline. RESULTS: The mean (standard deviation) change in BI score was -1.4 (5.7). The overall prevalence of sarcopenia was 21.1%, comprising 7.5% (non-severe) sarcopenia and 13.7% severe sarcopenia cases. In the multivariate analysis, the presence of sarcopenia was significantly associated with postoperative functional decline (β = -0.185, p = 0.001), whereas severe sarcopenia exhibited a stronger association with postoperative functional decline (β = -0.268, p < 0.001). CONCLUSIONS: These findings indicate that patients with severe sarcopenia require careful attention because of their higher risk of postoperative functional decline.