Nagano Fumihiko, Yoshimura Yoshihiro, Matsumoto Ayaka, Sato Yoichi, Abe Takafumi, Shimazu Sayuri, Shiraishi Ai, Bise Takahiro, Kido Yoshifumi, Hamada Takenori, Kuzuhara Aomi, Yoneda Kouki
Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan.
Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan.
Arch Gerontol Geriatr. 2025 Oct;137:105921. doi: 10.1016/j.archger.2025.105921. Epub 2025 May 31.
Cachexia is a common condition in stroke patients, yet its prevalence and impact on functional outcomes based on the Asian Working Group for Cachexia (AWGC) 2023 criteria remain unclear. This study aimed to determine the prevalence of cachexia and examine its association with functional prognosis in post-acute stroke patients capable of oral intake.
This retrospective cohort study included 856 post-stroke patients (mean (SD) age: 78 (7) years; 52 % men) admitted to a Japanese rehabilitation hospital between 2015 and 2023. Cachexia was diagnosed at admission using the AWGC 2023 criteria. Functional outcomes were assessed using the Functional Independence Measure (FIM)-motor score at discharge and FIM-motor gain. The association between cachexia and functional outcomes was analyzed using multiple linear regression, adjusting for age, sex, stroke type, baseline FIM-motor and FIM-cognitive scores, and other confounders.
Cachexia was diagnosed in 20 % (172/856) of patients. The mean (SD) length of hospital stay was 85 (44) days. Stroke types were cerebral infarction (n = 634, 74 %), cerebral hemorrhage (n = 188, 22 %), and subarachnoid hemorrhage (n = 34, 4 %). The most common underlying diseases were cancer (n = 120, 14 %), chronic heart failure (n = 52, 6 %), and chronic kidney disease (n = 26, 3 %). After adjusting for confounders, cachexia remained independently associated with lower FIM-motor at discharge (β=-0.092, P = 0.009) and lower FIM-motor gain (β=-0.079, P = 0.024).
Cachexia, as defined by the AWGC 2023 criteria, was prevalent in post-stroke patients and negatively impacted functional recovery. Early identification and targeted interventions may be essential for improving rehabilitation outcomes and quality of life.
恶病质在中风患者中很常见，但根据亚洲恶病质工作组（AWGC）2023标准，其患病率以及对功能结局的影响仍不明确。本研究旨在确定恶病质的患病率，并探讨其与能够经口进食的急性中风后患者功能预后的关联。
这项回顾性队列研究纳入了2015年至2023年间入住日本一家康复医院的856名中风后患者（平均（标准差）年龄：78（7）岁；52%为男性）。入院时使用AWGC 2023标准诊断恶病质。使用出院时的功能独立性测量（FIM）运动评分和FIM运动增益评估功能结局。使用多元线性回归分析恶病质与功能结局之间的关联，并对年龄、性别、中风类型、基线FIM运动和FIM认知评分以及其他混杂因素进行校正。
20%（172/856）的患者被诊断为恶病质。平均（标准差）住院时间为85（44）天。中风类型为脑梗死（n = 634，74%）、脑出血（n = 188，22%）和蛛网膜下腔出血（n = 34，4%）。最常见的基础疾病是癌症（n = 120，14%）、慢性心力衰竭（n = 52，6%）和慢性肾病（n = 26，3%）。校正混杂因素后，恶病质仍与出院时较低的FIM运动评分（β = -0.092，P = 0.009）和较低的FIM运动增益（β = -0.079，P = 0.024）独立相关。
根据AWGC 2023标准定义的恶病质在中风后患者中很普遍，并对功能恢复产生负面影响。早期识别和针对性干预可能对改善康复结局和生活质量至关重要。
