Relationship between Cachexia and the Functional Progress of Patients with Cancer in Inpatient Rehabilitation

Purpose Although inpatient rehabilitation can improve functional independence in patients with cancer, the role of cachexia in this population is unknown. Our objectives were to: 1) Establish prevalence of cachexia in a cohort of cancer patients receiving inpatient rehabilitation and its association with demographic and oncological history. 2) Determine the relationship between the presence of cachexia and functional recovery and whether these patients in inpatient rehabilitation have a distinct prognosis. Methods This is a retrospective cohort study of 250 patients over 330 admissions to an inpatient rehabilitation facility. Body weight loss threshold and Weight Loss Grading Scale identified patients with and without cachexia. Main outcomes were functional independence measure scores, discharge destination, and 6-mo survival. Results Prevalence of cachexia in inpatient rehabilitation was 59% using consensus body weight loss criteria, and 77% of cancer patients had a Weight Loss Grading Scale score greater than 0. Patients with and without cachexia had similar motor and cognitive gains, although patients with severe cachexia had more limited functional gains (P < 0.05) and increased odds of acute care return (P < 0.01). Patients with a Weight Loss Grading Scale score of 4 had decreased survival at 6 mos (P < 0.05) compared with noncachectic patients. Conclusions These data suggest that there is a relationship between cachexia and recovery for cancer patients that should be further studied in rehabilitation settings.