Lainscak Mitja, Zupanic Tina, Omersa Daniel, Erzen Ivan, Farkas Jerneja
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
General Hospital Murska Sobota, Murska Sobota, Slovenia.
J Cachexia Sarcopenia Muscle. 2025 Feb;16(1):e13688. doi: 10.1002/jcsm.13688.
Cachexia is a frequent companion of chronic diseases and a well-established predictor of poor patient performance and outcome. Since cachexia as a discharge diagnosis is not much investigated, we aimed to investigate prevalence of cachexia in hospitalised patients and their outcome.
We conducted a retrospective analysis of the National Hospital Health Care Statistics Database using the 10th revision of the International Classification of Diseases codes. During period 2004-2019, patients with cachexia were identified, as well as patients with cancer, heart failure, chronic obstructive pulmonary disease and chronic kidney disease. The primary endpoint was the discharge code of cachexia; secondary endpoints were length of hospital stay, in-hospital and post discharge all-cause mortality.
In period 2004-2019, 5 484 103 hospitalisations were screened; cachexia was coded 19 348 times (0.35%) in 14 089 patients (67 ± 13 years, 42% women). From 2004 to 2019, prevalence of cachexia increased steadily from 1.2% to 1.9%, which was most prominent for cancer and chronic obstructive pulmonary disease. At one year post discharge, 49% patients with cachexia were dead as compared to 26% in patients without cachexia. In Cox multivariate analysis, cachexia predicted post-discharge death in any of chronic diseases (hazard ratio of 1.28 in heart failure to 1.47 in chronic kidney disease).
In our report from a National Hospital Health Care Statistics Database, we found that cachexia was underreported as ICD-10 coded discharge diagnosis in patients with chronic diseases. When diagnosed, it was associated with higher hazard of post discharge mortality.
恶病质是慢性疾病的常见伴随症状，也是患者身体状况不佳和预后不良的公认预测指标。由于恶病质作为出院诊断的研究较少，我们旨在调查住院患者中恶病质的患病率及其预后。
我们使用国际疾病分类第10版代码对国家医院医疗保健统计数据库进行了回顾性分析。在2004年至2019年期间，识别出恶病质患者以及癌症、心力衰竭、慢性阻塞性肺疾病和慢性肾病患者。主要终点是恶病质的出院代码；次要终点是住院时间、住院期间和出院后的全因死亡率。
在2004年至2019年期间，共筛查了5484103例住院病例；14089例患者（67±13岁，42%为女性）中恶病质编码19348次（0.35%）。从2004年到2019年，恶病质的患病率从1.2%稳步上升至1.9%，在癌症和慢性阻塞性肺疾病中最为明显。出院后一年，恶病质患者中有49%死亡，而无恶病质患者中这一比例为26%。在Cox多变量分析中，恶病质可预测任何慢性疾病患者出院后的死亡（心力衰竭中的风险比为1.28，慢性肾病中为1.47）。
在我们基于国家医院医疗保健统计数据库的报告中，我们发现恶病质作为国际疾病分类第10版编码的出院诊断在慢性病患者中报告不足。一旦确诊，它与出院后更高的死亡风险相关。
