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Authors:
JA Diaz-Peromingo, M Rodriguez-Cordero, MA Valcarcel-Garcia, C Macia-Rodriguez, V Alende-Castro, I Novo-Veleiro, A Gonzalez-Quintela, Jose Antonio Diaz-Peromingo, Spain
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Abstract:
Background: Unintentional weight loss (UWL) is associated with increased morbidity and mortality. Etiology is wide and there are no specified predicting factors for underlying malignancy. Our objective is to examine the etiologies, characteristics, mortality, and need of hospital admissions in a cohort of outpatients with UWL.
Methods: We retrospectively reviewed patients referred to an outpatient quick diagnosis consultation for evaluation of UWL. A standard baseline evaluation with laboratory tests, chest X-ray, and abdominal ultrasonographic examination were performed in all patients. Patients without initial diagnosis were followed up for 6 months, and all patients for 5 years or death using electronic medical records.
Results: Overall 145 patients (mean age 70 [17.6] years; 50.3% males) were included. Predominant etiologies were non-malignant organic disorders (48.2%, mainly digestive diseases), malignancies (31%), and psychosocial disorders (10.4%). Malignancies, smoking, higher level of ESR, CRP, LDH, abnormal chest X-ray, and mortality were higher in males and patients aged ? 65 years. Patients with malignancies had a higher mortality rate and needed hospitalization more frequently than other groups. After initial work up, 10.4% patients remained without diagnosis. Elderly, male sex and the need of hospital admission were related to a final diagnosis of malignancy and the presence of an abnormal physical examination with early mortality.
Conclusion: Patients with UWL are mostly older, with non-malignant organic disorders, especially digestive diseases. Risk factors for underlying cancer are male sex, high level of ESR, CRP, LDH, and aged ? 65 years. Outpatient consultation seems to be the optimal setting to assess patients with UWL and few patients need hospital admission in our study. Mortality rate is high, especially in those patients with malignancy. Follow up is needed in patients with initially normal work up.
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