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Cachexia risk classification using the Asian Working Group for cachexia criteria in patients with dysphagia: A
Shingo Kakehi1, Hidetaka Wakabayashi1, Takako Nagai1
1Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Background & Aims:
Although diagnostic criteria for cachexia exist, few risk classification systems are applicable in clinical practice. This study aimed to evaluate the clinical relevance of a novel cachexia risk classification based on the Asian Working Group for Cachexia (AWGC) criteria in patients with dysphagia.
Methods:
This retrospective cohort study included 431 adult patients with dysphagia from a multicenter Japanese database. Sarcopenia and malnutrition were diagnosed using the AWGS 2019 and GLIM criteria, respectively. Patients were categorized into four original risk groups developed for this study based on AWGC criteria: No Risk (n = 255), Low Risk (n = 4), At Risk (n = 44), and Cachexia (n = 128). Low Risk group was excluded from analysis due to its small sample size. Mortality and functional outcomes were compared across the remaining three groups. Multinomial logistic regression was performed to identify factors independently associated with mortality.
Results:
Mortality was significantly higher in Cachexia group (15.6 %) compared to At Risk (2.2 %) and No Risk (1.9 %) groups (P < 0.01). BI and FILS did not differ significantly among groups. BMI and calf circumference declined with increasing cachexia risk. Malnutrition and sarcopenia were most prevalent in Cachexia group. Cachexia classification was independently associated with mortality (OR: 7.98, 95 % CI: 3.08-24.7, P < 0.01), and women were also associated with higher mortality risk (OR: 2.57, 95 % CI: 1.04-6.91, P = 0.03).
Conclusions:
Novel AWGC criteria for cachexia risk classification were significantly associated with mortality, malnutrition, and sarcopenia in patients with dysphagia.
