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Clinical nutrition, enteral and parenteral nutrition

Influence of additional criteria from a definition of cachexia on its prevalence—good or bad thing?

European Journal of Clinical Nutrition volume 67, pages 797–801 (2013)Cite this article

Subjects

Abstract

Background/Objectives:

Cachexia is a state of involuntary weight loss. The latest generic definition states that aside from weight loss, patient needs to fulfill additional criteria to be diagnosed with cachexia. New, condition-specific definitions also take the weight loss as a principal criterion, and additional criteria are not mandatory but are a part of further assessment. The aim of this study was to reveal the influence of additional criteria on the prevalence of cachexia in patients with various diseases linked to cachexia. Owing to this, we used the last generic definition. Possible differences in clinical presentations of patients with documented weight loss, with the respect of fulfillment of additional criteria were sought.

Subjects/Methods:

Clinical and anthropometric data on 137 consecutive patients with malignant diseases and chronic heart failure from a single institution were collected.

Results:

Fourty-two (30.6%) patients had >5% weight loss in the last 12 months. Only 30 (21.8%) of them were found to meet additional three out of five criteria proposed by the new definition. This observed difference in the prevalence of cachexia diagnosed with or without using additional criteria was found to be significant (P=0.0006). Comparison of clinical/laboratory data showed significantly higher levels of C-reactive protein and lower levels of albumin, as well as lower measurements of mid-arm circumference, triceps and suprailiac skinfolds in patients that fulfilled additional criteria. Survival analysis did not show reduced survival of patients fulfilling additional criteria.

Conclusions:

Additional criteria ‘reduce’ the prevalence of cachexia. They are indicative of differences in laboratory and clinical features of cachectic patients but do not influence their survival.

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Acknowledgements

All analyses presented in the study were done within the routine protocol of Clinical Hospital Merkur without additional sources of funding.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Cardiology, University Hospital Merkur, University of Zagreb School of Medicine, Zagreb, Croatia

    T Letilovic

  2. Department of Internal Medicine, Division of Hematology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia

    R Vrhovac

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  1. T Letilovic
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  2. R Vrhovac
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Correspondence to T Letilovic.

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The authors declare no conflict of interest.

Additional information

Contributors: TL gathered all the patients’ data and blood samples. TL contributed in the conception and design of the study, analysis and interpretation of the data, critical revision and final approval of the version that was submitted. RV also contributed in the conception and design of the study, analysis and interpretation of the data, critical revision and final approval of the version that was submitted in the design of the study and statistical analyses.

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Letilovic, T., Vrhovac, R. Influence of additional criteria from a definition of cachexia on its prevalence—good or bad thing?. Eur J Clin Nutr 67, 797–801 (2013). https://doi.org/10.1038/ejcn.2013.121

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