From the Shirley Ryan AbilityLab, Chicago, Illinois (IR, KH, AB, EM, JS, PJ); Northwestern University Feinberg School of Medicine, Chicago, Illinois (IR, KH, AB, EM, PJ); Robert H. Lurie Cancer Center, Northwestern University, Chicago, Illinois (IR); and Louisiana State University Medical School, New Orleans, Louisiana (JS).
Am J Phys Med Rehabil. 2023 Feb 1;102(2):99-104. doi: 10.1097/PHM.0000000000002024. Epub 2022 Apr 7.
Although inpatient rehabilitation can improve functional independence in patients with cancer, the role of cachexia in this population is unknown. Our objectives were to:1) Establish prevalence of cachexia in a cohort of cancer patients receiving inpatient rehabilitation and its association with demographic and oncological history.2) Determine the relationship between the presence of cachexia and functional recovery and whether these patients in inpatient rehabilitation have a distinct prognosis.
This is a retrospective cohort study of 250 patients over 330 admissions to an inpatient rehabilitation facility. Body weight loss threshold and Weight Loss Grading Scale identified patients with and without cachexia. Main outcomes were functional independence measure scores, discharge destination, and 6-mo survival.
Prevalence of cachexia in inpatient rehabilitation was 59% using consensus body weight loss criteria, and 77% of cancer patients had a Weight Loss Grading Scale score greater than 0. Patients with and without cachexia had similar motor and cognitive gains, although patients with severe cachexia had more limited functional gains ( P < 0.05) and increased odds of acute care return ( P < 0.01). Patients with a Weight Loss Grading Scale score of 4 had decreased survival at 6 mos ( P < 0.05) compared with noncachectic patients.
These data suggest that there is a relationship between cachexia and recovery for cancer patients that should be further studied in rehabilitation settings.
尽管住院康复可以提高癌症患者的功能独立性，但该人群中恶病质的作用尚不清楚。我们的目的是：1）确定接受住院康复治疗的癌症患者中恶病质的患病率及其与人口统计学和肿瘤学病史的关系。2）确定恶病质的存在与功能恢复之间的关系，以及这些住院康复患者是否具有独特的预后。
这是一项对 250 名患者的回顾性队列研究，共 330 人次入住住院康复机构。体重减轻阈值和体重减轻分级量表确定了有无恶病质的患者。主要结局是功能独立性测量评分、出院去向和 6 个月的生存情况。
使用共识性体重减轻标准，住院康复患者恶病质的患病率为 59%，77%的癌症患者体重减轻分级量表评分大于 0。有恶病质和无恶病质的患者在运动和认知方面的获益相似，尽管严重恶病质的患者在功能方面的获益更有限（P < 0.05），并且更有可能回到急性护理（P < 0.01）。体重减轻分级量表评分为 4 分的患者在 6 个月时的生存率降低（P < 0.05），与非恶病质患者相比。
这些数据表明，癌症患者的恶病质与恢复之间存在一定的关系，这在康复环境中应进一步研究。
