The prognostic significance of weight loss in chronic obstructive pulmonary disease‐related cachexia: a prospective cohort study

Autor: Hoi Yee Kwan, Matthew Maddocks, Claire M. Nolan, Sarah E. Jones, Suhani Patel, Ruth E. Barker, Samantha S.C. Kon, Michael I. Polkey, Paul Cullinan, William D.‐C. Man
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Journal of Cachexia, Sarcopenia and Muscle, Vol 10, Iss 6, Pp 1330-1338 (2019)
Druh dokumentu: article
ISSN: 2190-6009
2190-5991
DOI: 10.1002/jcsm.12463
Popis: Abstract Background Cachexia is an important extra‐pulmonary manifestation of chronic obstructive pulmonary disease (COPD) presenting as unintentional weight loss and altered body composition. Previous studies have focused on the relative importance of body composition compared with body mass rather than the relative importance of dynamic compared with static measures. We aimed to determine the prevalence of cachexia and pre‐cachexia phenotypes in COPD and examine the associations between cachexia and its component features with all‐cause mortality. Methods We enrolled 1755 consecutive outpatients with stable COPD from two London centres between 2012 and 2017, stratified according to European Respiratory Society Task Force defined cachexia [unintentional weight loss >5% and low fat‐free mass index (FFMI)], pre‐cachexia (weight loss >5% but preserved FFMI), or no cachexia. The primary outcome was all‐cause mortality. We calculated hazard ratios (HRs) using Cox proportional hazards regression for cachexia classifications (cachexia, pre‐cachexia, and no cachexia) and component features (weight loss and FFMI) and mortality, adjusting for age, sex, body mass index, and disease‐specific prognostic markers. Results The prevalence of cachexia was 4.6% [95% confidence interval (CI): 3.6–5.6] and pre‐cachexia 1.6% (95% CI: 1.0–2.2). Prevalence was similar across sexes but increased with worsening Global Initiative for Chronic Obstructive Pulmonary Disease spirometric stage and Medical Research Council dyspnoea score (all P
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