How is cachexia diagnosed?

How Is Cachexia Diagnosed?

In 2008, several scientists and clinicians came together in Washington, D.C. to form an agreed upon working definition of cachexia. During that conference, they came up with these diagnostic criteria for cachexia:

  1. Presence of a chronic disease;
  2. Loss of body weight greater than or equal to 5% within the previous 12 months or less; and
  3. Presence of at least three of the following: reduced muscle strength, fatigue, anorexia, low fat-free mass index, abnormal biochemistry, inflammation, anemia, low albumin

The National Cancer Institute posts these criteria for diagnosing cachexia in cancer patients:

  • Weight loss greater than 5% over the past 6 months; or
  • BMI less than 20 and any degree of weight loss greater than 2%;
  • Appendicular skeletal muscle index consistent with sarcopenia (another wasting syndrome) and weight loss of more than 2%

Methods for assessing patients can include measuring body mass index (BMI), lean muscle mass, food intake journals, and blood tests.

Recently, researchers developed a cachexia staging score (CSS) for advanced cancer patients in

order to clarify the three-level staging system:

  • Weight loss in 6 months (0-3)
  • A simple SARC-F questionnaire that assesses muscle function and sarcopenia (0-3)
  • ECOG performance status (0-3)
  • Appetite loss (0-2)
  • Abnormal lab tests (0-2)

The physician scores the patient for each category. The the combined score determines the patent’s category:

  • Non-cachexia (0-2)
  • Pre-cachexia (3-4)
  • Cachexia (5-8)
  • Refractory cachexia (9-12)