Archives of gerontology and geriatrics · 2025
Cachexia defined by the Asian Working Group for Cachexia 2023 criteria as a determinant of functional recovery in post-stroke patients capable of oral intake.
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Nagano Fumihiko, Yoshimura Yoshihiro, Matsumoto Ayaka, Sato Yoichi, Abe Takafumi, Shimazu Sayuri, Shiraishi Ai, Bise Takahiro, Kido Yoshifumi, Hamada Takenori, Kuzuhara Aomi, Yoneda Kouki
Аннотация
BACKGROUND AND AIMS: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSION: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSION: 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.