The Prevalence and Prognosis of Cachexia in Patients with Non-Sarcopenic Dysphagia: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patients
2.2. Diagnosis of Sarcopenic Dysphagia
2.3. Cachexia Diagnostic Criteria
- Subjective symptom: loss of appetite;
- Objective measure: reduced grip strength (less than 28 kg in men and less than 18 kg in women);
- Biomarker: increased C-reactive protein (CRP) levels (greater than 0.5 mg/dL).
2.4. Outcomes and Other Data
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total n = 175 | Cachexia (+) n = 30 | Cachexia (−) n = 145 | p-Value | |
---|---|---|---|---|
Age, years, mean ± SD * | 77 ± 11 | 78 ± 9 | 77 ± 11 | 0.437 a |
Sex, n (%) | 0.103 b | |||
Men | 103 (59%) | 22 (73%) | 81 (56%) | |
Women | 72 (41%) | 8 (27%) | 64 (44%) | |
Setting, n (%) | 0.001 b | |||
Acute care hospitals | 78 (45%) | 23 (77%) | 55 (38%) | |
Rehabilitation hospitals | 76 (43%) | 4 (13%) | 72 (50%) | |
Others | 21 (12%) | 3 (10%) | 18 (12%) | |
Main causative diseases of dysphagia, n (%) | ||||
Cerebral infarction | 77 (44%) | 9 (30%) | 68 (47%) | 0.113 b |
Cerebral hemorrhage | 19 (11%) | 2 (7%) | 17 (12%) | 0.536 b |
Subarachnoid hemorrhage | 9 (5%) | 0 (0%) | 9 (6%) | 0.361 b |
Parkinsonism | 15 (9%) | 5 (17%) | 10 (7%) | 0.142 b |
Dementia | 12 (7%) | 3 (10%) | 9 (6%) | 0.435 b |
Cancer | 8 (5%) | 7 (23%) | 1 (1%) | <0.001 b |
Others | 35 (20%) | 4 (13%) | 31 (21%) | 0.453 b |
Comorbidities, n (%) | ||||
Chronic heart failure | 21 (12%) | 9 (30%) | 12 (8%) | <0.001 b |
Cancer | 13 (7%) | 15 (50%) | 8 (6%) | <0.001 b |
Chronic renal failure | 8 (5%) | 3 (10%) | 5 (3%) | 0.139 b |
Chronic obstructive pulmonary disease | 8 (5%) | 4 (13%) | 4 (3%) | 0.030 |
Chronic respiratory failure | 0 (0%) | 0 (0%) | 0 (0%) | - |
Progressive worsening or uncontrolled chronic infections | 0 (0%) | 0 (0%) | 0 (0%) | - |
Chronic liver failure | 0 (0%) | 0 (0%) | 0 (0%) | - |
Rheumatoid arthritis and other collagen diseases | 0 (0%) | 0 (0%) | 0 (0%) | - |
Sarcopenia, n (%) | 133 (76%) | 26 (87%) | 107 (74%) | 0.133 |
Malnutrition, n (%) | 92 (53%) | 19 (63%) | 73 (50%) | 0.181 |
Body mass index, kg/m2, mean ± SD * | 21.0 ± 4.0 | 18.9 ± 3.0 | 21.4 ± 4.0 | <0.001 a |
Body weight change in 6 months, %, median (IQR **) | 3.3 (−1.9, 12.7) | 11.0 (3.3, 19.7) | 1.5 (−3.5, 10.5) | 0.074 c |
Handgrip strength, kg, mean ± SD * | 16.5 ± 10.9 | 15.2 ± 10.2 | 16.8 ± 11.1 | 0.467 a |
C-reactive protein, mg/dL, median (IQR **) | 0.5 (0.1, 1.9) | 3.4 (0.8, 11.6) | 0.3 (0.1, 1.0) | <0.001 c |
FILS *** initial, median (IQR **) | 7 (1, 7) | 2 (1, 7) | 7 (1, 7) | 0.160 c |
FILS follow-up, median (IQR **) | 8 (7, 8) | 7 (5.5, 8) | 8 (7, 8) | 0.585 c |
Barthel Index initial, median (IQR **) | 25 (10, 50) | 25 (5, 67.5) | 30 (10, 50) | 0.406 c |
Barthel Index follow-up, median (IQR **) | 50 (20, 85) | 35 (12.5, 75) | 50 (20, 85) | 0.469 c |
Death, n (%) | 7 (4%) | 5 (17%) | 2 (1%) | 0.002 b |
No | Sex | Causative Disease of Admission | Cause of Death | Sarcopenia | Malnutrition | Cachexia |
---|---|---|---|---|---|---|
1 | Woman | Urinary tract infection | Senility | + | + | + |
2 | Man | Gastric cancer | Systemic metastatic cancer | + | − | + |
3 | Man | Colorectal cancer | Colorectal cancer | + | + | + |
4 | Man | Urinary tract infection | Pyothorax | + | + | + |
5 | Man | Cardiogenic cerebral embolism | Unknown | + | + | + |
6 | Woman | Cerebral infarction | Stroke | + | + | − |
7 | Woman | Multiple system atrophy | Septic shock | + | + | − |
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Share and Cite
Kakehi, S.; Wakabayashi, H.; Nagai, T.; Nishioka, S.; Isono, E.; Otsuka, Y.; Ninomiya, J.; Momosaki, R. The Prevalence and Prognosis of Cachexia in Patients with Non-Sarcopenic Dysphagia: A Retrospective Cohort Study. Nutrients 2024, 16, 2917. https://doi.org/10.3390/nu16172917
Kakehi S, Wakabayashi H, Nagai T, Nishioka S, Isono E, Otsuka Y, Ninomiya J, Momosaki R. The Prevalence and Prognosis of Cachexia in Patients with Non-Sarcopenic Dysphagia: A Retrospective Cohort Study. Nutrients. 2024; 16(17):2917. https://doi.org/10.3390/nu16172917
Chicago/Turabian StyleKakehi, Shingo, Hidetaka Wakabayashi, Takako Nagai, Shinta Nishioka, Eri Isono, Yukiko Otsuka, Junki Ninomiya, and Ryo Momosaki. 2024. "The Prevalence and Prognosis of Cachexia in Patients with Non-Sarcopenic Dysphagia: A Retrospective Cohort Study" Nutrients 16, no. 17: 2917. https://doi.org/10.3390/nu16172917