Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo 162-8666, Japan.
Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan.
Nutrients. 2024 Sep 1;16(17):2917. doi: 10.3390/nu16172917.
The purpose of this study was to assess the prevalence and prognosis of cachexia in patients with non-sarcopenic dysphagia. A retrospective cohort study was conducted using the Japanese sarcopenic dysphagia database. Cachexia was diagnosed using the Asian Working Group for Cachexia criteria, sarcopenia using the Asian Working Group for Sarcopenia 2019 criteria, and malnutrition using the Global Leadership Initiative on Malnutrition criteria. Outcomes were death, swallowing function (Food Intake LEVEL Scale (FILS)), and activities of daily living (Barthel Index (BI)). The mean age of the 175 non-sarcopenic dysphagia patients was 77 (±11) years; 103 (59%) were male, 30 (17%) had cachexia, 133 (76%) had whole-body sarcopenia, and 92 (53%) were malnourished. Of the 30 patients with cachexia, 4 and 11 did not have sarcopenia and malnutrition, respectively. No significant associations were found between cachexia, sarcopenia, and malnutrition. Death was notably higher in the cachexia group (5/30; 17% vs. 2/145; 1%, = 0.002). Median FILS (7 vs. 8, = 0.585) and median BI (35 vs. 50, = 0.469) scores did not show significant differences based on cachexia status. The prevalence of cachexia was 17%, and mortality may be higher with cachexia in non-sarcopenic dysphagia patients.
本研究旨在评估非肌肉减少性吞咽困难患者中恶病质的患病率和预后。采用日本肌肉减少性吞咽困难数据库进行回顾性队列研究。采用亚洲工作组恶病质标准诊断恶病质,采用亚洲工作组 2019 年肌肉减少症标准诊断肌肉减少症,采用全球营养不良领导倡议标准诊断营养不良。结局指标为死亡、吞咽功能(食物摄入水平量表(FILS))和日常生活活动能力(巴氏指数(BI))。175 例非肌肉减少性吞咽困难患者的平均年龄为 77(±11)岁;103 例(59%)为男性,30 例(17%)患有恶病质,133 例(76%)患有全身肌肉减少症,92 例(53%)患有营养不良。在 30 例恶病质患者中,分别有 4 例和 11 例无肌肉减少症和营养不良。恶病质、肌肉减少症和营养不良之间无显著相关性。恶病质组死亡率明显较高(5/30;17%比 2/145;1%, = 0.002)。根据恶病质状态,FILS 中位数(7 比 8, = 0.585)和 BI 中位数(35 比 50, = 0.469)评分无显著差异。恶病质的患病率为 17%,非肌肉减少性吞咽困难患者恶病质的死亡率可能更高。