Consensus on cachexia definitions

摘要

Cachexia is a term originating from the Greek "kakos" and "hexis" meaning "bad condition." The cachectic state is observed in many pathological conditions such as cancer, chronic obstructive pulmonary disease, sepsis, or chronic heart failure. For several years it has been considered key to develop a standardized definition of cachexia. This represents a key issue for treatment, for reimbursement, and for inclusion and exclusion from clinical trials. The definition and diagnostic criteria must be clear to identify the early signs. Also a key point, the definition must include an appreciation that cachexia is found in a number of life-limiting illnesses and that the management of this syndrome at the end of life must be facilitated, albeit that this is not done the same way as in earlier stages. In the past few years, 3 different cachexia definitions have been published. A consensus is, therefore, needed. The definition could be used by many interests: American Association of Enteral and Parenteral Nutrition (ASPEN), European Society for Enteral and Parenteral Nutrition (ESPEN), the Food and Drug Administration, gerontologists, cardiologists, oncologists, specialists in palliative medicine, industry, and so forth.