Impaired functional recovery following cardiovascular surgery remains a clinically relevant postoperative complication. In this retrospective study of 231 consecutive patients undergoing elective cardiovascular surgery, investigators examined whether preoperative respiratory sarcopenia independently predicts impaired recovery. The study was published in the Canadian Journal of Cardiology.

Respiratory sarcopenia was defined by reduced respiratory muscle strength (% peak expiratory flow rate <80%) and low respiratory muscle mass, determined as the lowest quartile of diaphragm thickness index (diaphragm thickness/body mass index ×100) measured on computed tomography. The primary outcome was a decline of ≥1 point in the Short Physical Performance Battery (SPPB) score on postoperative day 14 compared with baseline.

Respiratory sarcopenia was identified in 40 patients (17.3%). In multivariable logistic regression adjusted for clinical covariates and systemic sarcopenia, respiratory sarcopenia independently predicted impaired functional recovery (odds ratio 3.22; 95% CI 1.36–7.64). Incorporating respiratory sarcopenia into the baseline model improved risk reclassification (net reclassification improvement 0.36; integrated discrimination improvement 0.037).

Preoperative respiratory sarcopenia was independently associated with early postoperative functional decline. These findings describe its incremental prognostic value in this surgical population.