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Vol. 152. Issue 10.
Pages 384-390 (May 2019)
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Vol. 152. Issue 10.
Pages 384-390 (May 2019)
Original article
DOI: 10.1016/j.medcle.2019.03.008
Isolated involuntary weight loss: Epidemiology and predictive factors of malignancy
Pérdida de peso involuntaria aislada: epidemiología y factores predictivos de malignidad
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Joaquim Torné Cachot
Corresponding author
18112jtc@comb.cat

Corresponding author.
, José Manuel Baucells Azcona, Jesús Blanch Falp, Javier García Pont, Helena Camell Ilari
Servicio de Medicina Interna, Hospital Sant Camil, Consorci Sanitari del Garraf, San Pere de Ribes, Barcelona, Spain
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Tables (5)
Table 1. Diseases diagnosed in the study.
Table 2. Clinical, diagnostic and progression characteristics according to diagnostic categories.
Table 3. STM in patients with IIWL according to cancer location and staging.
Table 4. Patient characteristics according to clinical progression time.
Table 5. Variables identified in the multivariate analysis as predictors of malignancy.
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Abstract
Background and objectives

The aims of the study were to analyse the epidemiology, prognostic and predictive factors of malignant disease on isolated involuntary weight loss (IIWL) and to know the effectiveness of the quick diagnosis unit in the evaluation of the process.

Materials and methods

Prospective observational study realised from 2006 to 2015 of all patients who were evaluated with IIWL in the quick diagnosis unit. Demographic, clinical, diagnostic and evolutive variables were analysed. Through the analysis of logistic regression, predictive factors of malignant disease and prognostic factors were identified.

Results

Of the 533 registered patients, 55.1% were ≥65 years old. The diagnostics were: non-neoplastic organic disorders in 214 patients (40.2%), psychiatric disorders in 144 (27%), cancer in 81 (15.2%) and unknown cause in 94 (17.6%). In 66.7% of the patients with cancer, there was an increase of serum tumour markers (STM). Being over 60 (OR: 2.57; 95% CI: 1.27–5.77; p=0.01), male (OR: 3.23; 95% CI: 1.52–6.87; p=0.002), increase of an STM (OR: 2.38; 95% CI: 1.17–4.8; p=0.016) and more than one STM (OR: 6.51; 95% CI: 2.62–16.13; p=0.000) were identified as predictive factors of malignancy. Mortality was 14.2%; the diagnosis of cancer (OR: 47.61; 95% CI: 20.76–109.19; p=0.000) was identified as a prognostic factor.

Conclusions

IIWL is a clinical syndrome that requires a study with a sequential protocol and follow-up. STM were identified as predictive factors of malignancy.

Keywords:
Isolated involuntary weight loss
Quick diagnosis unit
Prognosis
Predictive factors of malignant disease
Serum tumour markers
Resumen
Fundamento y objetivos

Los objetivos del estudio han sido analizar la epidemiología, el pronóstico y los factores predictivos de enfermedad maligna de la pérdida de peso involuntaria aislada (PPIA) y conocer la efectividad de una unidad de diagnóstico rápido en la evaluación del proceso.

Material y métodos

Estudio prospectivo observacional realizado en el período de 2006-2015 de todos los pacientes evaluados de PPIA en la unidad de diagnóstico rápido. Se analizaron variables demográficas, clínicas, diagnósticas y evolutivas. Mediante un análisis de regresión logística se identificaron los factores predictivos de enfermedad maligna y factores pronósticos.

Resultados

De los 533 pacientes registrados, el 55,1% tenían una edad65 años. Los diagnósticos fueron: trastornos orgánicos no neoplásicos en 214 pacientes (40,2%), trastornos psiquiátricos en 144 (27%), cáncer en 81 (15,2%) y causa desconocida en 94 (17,6%). En el 66,7% de los pacientes con cáncer existía el aumento de algún marcador tumoral sérico (MTS). La edad>60 años (OR: 2,71; IC 95%: 1,27-5,77; p=0,01), el género masculino (OR: 3,23; IC 95%: 1,52-6,87; p=0,002), el aumento de un MTS (OR: 2,38; IC 95%: 1,17-4,8; p=0,016) y más de un MTS (OR: 6,51; IC 95%: 2,62-16,13; p=0,000) se identificaron como factores predictivos de enfermedad maligna. La mortalidad fue del 14,2%, asociándose como factor pronóstico el diagnóstico de cáncer (OR: 47,61; IC 95%: 20,76-109;19; p=0,000).

Conclusiones

La PPIA es un síndrome clínico que requiere un estudio protocolizado secuencial y un seguimiento. Los MTS se han identificado como factores predictivos de enfermedad maligna.

Palabras clave:
Pérdida de peso involuntaria aislada
Unidad de diagnóstico rápido
Pronóstico
Factores predictivos de enfermedad maligna
Marcadores tumorales séricos

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