e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

The prevalence of cachexia and symptom burden in a palliative cohort (#380)

Davinia Seah 1 2 3 , Mary Rose Birch 1 , Richard Chye 1
  1. Sacred Heart Supportive and Palliative Care Service, St Vincents' Hospital Sydney, Darlinghurst, New South Waless, Australia
  2. School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia
  3. University of New South Wales, Sydney, New South Wales, Australia

Background

The SCRINIO working group defined cachexia as weight loss of >10% and the presence of at least 1 symptom of anorexia, fatigue, or early satiation. The aim of this study is to describe the prevalence of cachexia and symptom burden in a palliative care cohort.

 

Methods

In conjunction with a bio-banking study, we conducted a survey on consecutive patients who were referred to the Sacred Heart Palliative Care Service, Sydney, between Sept 2017 and April 2021. Data such as Charlton Comorbidity Index, EORTC QLQ-CAX24, Edmonton Symptom Assessment and Patient Generated-Subjective Global Assessment (PG-SGA) were collected.

 

Results

Preliminary findings showed that 51%(n=57) of the 113 (N) participants were male. The median age was 68.5 (range 36.4 to 96.3) years. Most patients (n=78, 70%) had a solid tumour, 13% COPD (n=15) and 12% (n=13) had diabetes mellitus. The median Australian-modified Karnofksy score was 70 (IQR 50-80).

 

The median Body Mass Index (BMI) was 23 (range: 13.5-41.9) kg/m2. Forty patients (35%) reported having gained weight, and 69 patients (61%) lost weight. Twenty-three patients (20%) met the criteria for cachexia. About 42% (n=47) of patients had moderate to severe malnourishment according to the PG-SGA.

 

Almost 50% (n=55) reported eating less normal food. The most common reasons for not eating include fatigue(n=50, 45%) having no appetite (n=50,45%), early satiety (n=45, 40%) and a dry mouth (n=45, 40%). Patients were worried about becoming more dependent on others (56%), having a dry mouth (48%), changes in their daily life (n=10, 40%). There were statistically significant associations between cachexic patients and worrying about weight loss (46% versus 14%, P=0.001).

 

Conclusion

A significant proportion of patients met the criteria for cachexia. There was an association between cachexic patients and worry about weight loss. Interventions to address cachexia and their concerns should be further explored given its prevalence.

 

  1. Federico Bozzetti, Luigi Marinai. 2009, 'Defining and classifying cancer cachexia: a proposal by the SCRINIO working group', Journal of Parenteral Enteral Nutrition, Jul-Aug ;33(4):361-7