Back to Search
Start Over
Clinical utility of the modified Glasgow Prognostic Score to classify cachexia in patients with advanced cancer in palliative care
- Source :
- Clinical nutrition (Edinburgh, Scotland). 39(5)
- Publication Year :
- 2019
-
Abstract
- Summary Background & aims It is a challenge in clinical practice to identify and classify cancer cachexia. Currently, it has been extensively discussed if the presence of alterations in inflammatory biomarkers implies the presence of cachexia. This study aimed to evaluate the clinical relevance of cachexia classification through modified Glasgow Prognostic Score (mGPS) in advanced cancer patients in palliative care. Methods Observational prospective cohort study conducted at a Palliative Care Unit in Brazil. Cachexia classification was performed according to mGPS (based on albumin and C-reactive protein) in four different stages: no cachexia (NCa), undernourished (Un), pre cachexia (PCa), and refractory cachexia (RCa). Logistic regression models were used to test the association between cachexia stages and clinical, nutritional and functional domains. Kaplan–Meier curve and Cox multivariate model were used to analyze overall survival (OS). Results A total of 1166 patients were included in the study. According to the cachexia framework 37.5% were NCa, 32.3% Un, 3.9% PCa and 26.4% RCa. Significant differences were observed among cachexia stages for most of the outcome measures. This classification was able to predict mortality in 90 days [Un (HR, 1.55; 95% CI, 1.25; 1.93); PCa (HR, 2.00; 95% CI, 1.34; 2.98); RCa (HR, 2.45; 95% CI, 1.34; 2.98)]. Conclusion Cachexia stages were associated with significant differences in poor clinical outcomes and were also capable of predicting OS. This framework based on simple and objective criteria can be used as part of the routine to characterize the presence and stages of cachexia in advanced cancer patients.
- Subjects :
- 0301 basic medicine
Oncology
Male
medicine.medical_specialty
Palliative care
Cachexia
030209 endocrinology & metabolism
Critical Care and Intensive Care Medicine
Logistic regression
Prognostic score
03 medical and health sciences
0302 clinical medicine
Internal medicine
Neoplasms
medicine
Humans
In patient
Clinical significance
Prospective cohort study
Aged
030109 nutrition & dietetics
Nutrition and Dietetics
business.industry
digestive, oral, and skin physiology
Palliative Care
Middle Aged
medicine.disease
Advanced cancer
Female
business
Biomarkers
Subjects
Details
- ISSN :
- 15321983
- Volume :
- 39
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Clinical nutrition (Edinburgh, Scotland)
- Accession number :
- edsair.doi.dedup.....6f2c007a41515ea297e8587124066799