Abstract
OBJECTIVE: This systematic review examined if temporal muscle thickness (TMT) as a surrogate marker of sarcopenia was a predictor of outcomes after stroke. METHODS: We explored the PubMed, Embase, Scopus, and Web of Science databases till 18th January 2025 for studies reporting stroke prognosis based on baseline TMT. Pooled analyses examined associations with post-stroke mortality, functional outcomes, and dysphagia. Meta-regression was conducted using baseline NIHSS and TMT values as moderators. RESULTS: Nine studies were available. Meta-analysis showed that low TMT was associated with a statistically significant increase in the risk of post-stroke mortality (OR: 1.42 95% CI: 1.03, 1.96 I (2) = 43%). A pooled analysis of five studies showed that there was a tendency for good functional outcomes with high TMT (OR: 1.24 95% CI: 1.00, 1.54 I (2) = 75%). But the results were non-significant. Two studies showed that baseline TMT was significantly associated with an increased risk of dysphagia. Meta-regression did not identify significant moderating effects. CONCLUSION: Preliminary evidence suggests that lower TMT is associated with higher mortality after stroke, while associations with functional recovery remain inconclusive. Current limitations, including heterogeneity and lack of sex-specific analyses, preclude routine clinical use. Further standardized and patient-level research is warranted. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42025637925.