Cachexia among US cancer patients.
BACKGROUND
Cancer cachexia is a debilitating condition and results in poor prognosis. The purpose of this study was to assess hospitalization incidence, patient characteristics, and medical cost and burden of cancer cachexia in the US.


METHODS
This study used a cross-sectional analysis of the Nationwide Inpatient Sample (NIS) for 2009. Five cancers reported to have the highest cachexia incidence were assessed. The hospitalization incidence related to cachexia was estimated by cancer type, cost and length of stay were compared, and descriptive statistics were reported for each cancer type, as well as differences being compared between patients with and without cachexia.


RESULTS
Risk of inpatient death was higher for patients with cachexia in lung cancer (OR = 1.32; CI = 1.20-1.46) and in all cancers combined (OR = 1.76; CI = 1.67-1.85). The presence of cachexia increased length of stay in lung (IRR = 1.05; CI = 1.03-1.08), Kaposi's sarcoma (IRR = 1.47; CI = 1.14-1.89) and all cancers combined (IRR = 1.09; CI = 1.08-1.10). Additionally, cachectic patients in the composite category had a longer hospitalization stay compared to non-cachectic patients (3-9 days for those with cachexia and 2-7 days for those without cachexia). The cost of inpatient stay was significantly higher in cachexic than non-cachexic lung cancer patients ($13,560 vs $13 190; p < 0.0001), as well as cachexic vs non-cachexic cancer patients in general (14 751 vs 13 928; p < 0.0001).


CONCLUSIONS
Cachexia increases hospitalization costs and length of stay in several cancer types. Identifying the medical burden associated with cancer cachexia will assist in developing an international consensus for recognition and coding by the medical community and ultimately an effective treatment plans for cancer cachexia.
a University of North Carolina at Charlotte , Charlotte , NC , USA.
Susan T
ST
Arthur
a University of North Carolina at Charlotte , Charlotte , NC , USA.
Bryce A
BA
Van Doren
a University of North Carolina at Charlotte , Charlotte , NC , USA.
Debosree
D
Roy
a University of North Carolina at Charlotte , Charlotte , NC , USA.
Joshua M
JM
Noone
a University of North Carolina at Charlotte , Charlotte , NC , USA.
Emily
E
Zacherle
a University of North Carolina at Charlotte , Charlotte , NC , USA.
Christopher M
CM
Blanchette
D000367:Age Factors; D000368:Aged; D002100:Cachexia / Q000191:economics* / Q000209:etiology* / Q000401:mortality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012737:Sex Factors; D012959:Socioeconomic Factors
Anorexia-cachexia syndrome; Esophageal cancer; Hospitalization stays; Inpatient cost; Lung cancer; Nationwide inpatient sample; Pancreatic cancer; Skeletal muscle; Stomach cancer; Wasting syndrome