Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Nutrition. 2024 Jun;122:112385. doi: 10.1016/j.nut.2024.112385. Epub 2024 Feb 6.
The aim to examine the prevalence and prognosis of cachexia according to the Asian Working Group for Cachexia (AWGC) criteria in patients with sarcopenic dysphagia.
A retrospective cohort study was conducted with 271 patients diagnosed with sarcopenic dysphagia out of 467 patients enrolled in the Japanese sarcopenic dysphagia database. Cachexia was diagnosed by the AWGC criteria. The AWGC criteria includes chronic diseases, either or both weight loss (2% or more over 3-6 mo) or low BMI (<21 kg/m), and at least one of the following: anorexia, decreased grip strength (<28 kg in men and <18 kg in women), or elevated C-reactive protein levels (>0.5 mg/dL). Outcomes were death, swallowing function as assessed by the Food Intake LEVEL Scale (FILS), and activities of daily living as assessed by the Barthel Index (BI) at follow-up.
The mean age was 84 (±8) y; 152 (56%) were female, and 97 (36%) had cachexia. In univariate analysis, death was significantly more common in the cachexia group (15% versus 2%, P ≤ 0.001). Logistic regression analysis showed that cachexia was independently associated with death (odds ratio: 3.557, 95% confidence interval: 1.010, 12.529). No significant differences were found in the presence or absence of cachexia in the FILS (7 versus 8, P = 0.849) and BI (55 versus 52.5, P = 0.892).
Cachexia was found in 36% of patients with sarcopenic dysphagia, and death was significantly higher in cachexia.
根据亚洲肌肉减少症工作组(AWGC)标准,检查肌少性吞咽困难患者中恶病质的患病率和预后。
对纳入日本肌少性吞咽困难数据库的 467 例患者中的 271 例肌少性吞咽困难患者进行回顾性队列研究。采用 AWGC 标准诊断恶病质。AWGC 标准包括慢性疾病、体重减轻(3-6 个月内 2%或以上)或 BMI 降低(<21kg/m),且至少存在以下一项:厌食、握力下降(男性<28kg,女性<18kg)或 C 反应蛋白水平升高(>0.5mg/dL)。结局为死亡、随访时通过食物摄入水平量表(FILS)评估的吞咽功能和通过巴氏指数(BI)评估的日常生活活动能力。
患者平均年龄为 84(±8)岁;152 例(56%)为女性,97 例(36%)患有恶病质。单因素分析显示,恶病质组死亡人数明显更多(15%比 2%,P≤0.001)。Logistic 回归分析显示,恶病质与死亡独立相关(优势比:3.557,95%置信区间:1.010,12.529)。存在或不存在恶病质时,FILS(7 比 8,P=0.849)和 BI(55 比 52.5,P=0.892)无显著差异。
肌少性吞咽困难患者中有 36%存在恶病质,恶病质患者死亡风险显著更高。