使用亚洲工作组对吞咽困难患者恶病质标准进行恶病质风险分类：一项回顾性队列研究。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-09 DOI:10.1016/j.clnesp.2025.09.007

Shingo Kakehi , Hidetaka Wakabayashi , Takako Nagai , Eri Isono , Junki Ninomiya , Yukiko Otsuka , Shinta Nishioka , Ryo Momosaki

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引用次数: 0

摘要

背景与目的：虽然存在恶病质的诊断标准，但临床应用的风险分类系统很少。本研究旨在评估一种基于亚洲恶病质工作组（AWGC）标准的新型恶病质风险分类在吞咽困难患者中的临床意义。方法：这项回顾性队列研究纳入了来自日本多中心数据库的431名成年吞咽困难患者。分别使用AWGS 2019和GLIM标准诊断肌肉减少症和营养不良。根据AWGC标准，将患者分为4个原始风险组：无风险（n = 255）、低风险（n = 4）、有风险（n = 44）和恶病质（n = 128）。低风险组因样本量小而被排除在分析之外。对其余三组的死亡率和功能结果进行比较。采用多项逻辑回归来确定与死亡率独立相关的因素。结果：恶病质组病死率（15.6%）明显高于At Risk组（2.2%）和No Risk组（1.9%）（P < 0.01）。BI和FILS组间差异无统计学意义。BMI和小腿围随着恶病质风险的增加而下降。恶病质组以营养不良和肌肉减少最为常见。恶病质分类与死亡率独立相关（OR: 7.98, 95% CI: 3.08-24.7, P < 0.01），女性也与较高的死亡风险相关（OR: 2.57, 95% CI: 1.04-6.91, P = 0.03）。结论：新的AWGC恶病质风险分类标准与吞咽困难患者的死亡率、营养不良和肌肉减少症显著相关。

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Cachexia risk classification using the Asian Working Group for cachexia criteria in patients with dysphagia: A retrospective cohort study

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.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.