Exploring the prevalence, impact and experience of cardiac cachexia in patients with advanced heart failure and their caregivers: a sequential phased study

Matthew A Carson, Joanne Reid, Loreena Hill, Lana Dixon, Patrick Donnelly, Paul Slater, Alyson Hill, Susan E Piper, Theresa A McDonagh, Donna Fitzsimons*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background:
Cardiac Cachexia is a wasting syndrome that has a significant impact on patient mortality and quality of life world-wide, although it is poorly understood in clinical practice.

Aim:
Identify the prevalence of cardiac cachexia in patients with advanced New York Heart Association (NYHA) functional class and explore its impact on patients and caregivers.

Design:
An exploratory cross-sectional study. The sequential approach had two phases, with phase 1 including 200 patients with NYHA III-IV heart failure assessed for characteristics of cardiac cachexia. Phase 2 focussed on semi-structured interviews with eight cachectic patients and five caregivers to ascertain the impact of the syndrome.

Setting/participants:
Two healthcare trusts within the United Kingdom.

Results:
Cardiac Cachexia was identified in 30 out of 200 participants, giving a prevalence rate of 15%. People with cachexia had a significantly reduced average weight and anthropometric measures (p < 0.05). Furthermore, individuals with cachexia experienced significantly more fatigue, had greater issues with diet and appetite, reduced physical wellbeing and overall reduced quality of life. C-reactive protein was significantly increased, whilst albumin and red blood cell count were significantly decreased in the cachectic group (p < 0.05). From qualitative data, four key themes were identified: (1) ‘Changed relationship with food and eating’, (2) ‘Not me in the mirror’, (3) ‘Lack of understanding regarding cachexia’ and (4) ‘Uncertainty regarding the future’.

Conclusions:
Cardiac cachexia has a debilitating effect on patients and caregivers. Future work should focus on establishing a specific definition and clinical pathway to enhance patient and caregiver support.

Original languageEnglish
Pages (from-to)1118-1128
Number of pages11
JournalPalliative Medicine
Volume36
Issue number7
Early online date21 Jun 2022
DOIs
Publication statusPublished - Jul 2022

Keywords

  • Prevalence
  • sequential phased
  • qualitative
  • Humans
  • Caregivers
  • Heart Failure - complications
  • Cachexia - epidemiology - etiology
  • quantitative
  • Quality of Life
  • Cachexia
  • caregiver
  • Cross-Sectional Studies
  • prevalence
  • heart failure

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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