Association Between Cachexia Defined by the Asian Working Group for Cachexia Criteria and One-Year Post-Discharge Mortality in Older Adults with Acute Decompensated Heart Failure

Background: Cachexia is a well-known clinically important condition in older adults with heart failure, but evidence regarding cachexia defined by the Asian Working Group for Cachexia (AWGC) criteria in those with acute decompensated heart failure (ADHF) remains limited. Methods: This prospective observational study included 78 patients aged 65 years or older who were hospitalized for ADHF. Cachexia on admission was diagnosed using the AWGC criteria. The primary outcome was all-cause mortality within one year after discharge and the secondary outcome was all-cause readmission within the same period. Results: Cachexia was diagnosed in 26 patients (33.3%). Compared with the patients without cachexia, those with cachexia were older and had a lower body mass index, poorer nutritional status, and reduced physical function. Cachexia was associated with a significantly higher risk of all-cause mortality after discharge. In the adjusted Cox proportional hazards model, cachexia remained significantly associated with all-cause mortality within one year after discharge (HR, 3.04), whereas no significant association was observed with all-cause readmission. Conclusions: Among older adults hospitalized for ADHF, AWGC-defined cachexia on admission was associated with increased all-cause mortality within one year after discharge. Although these findings suggest that AWGC-defined cachexia may be useful for identifying a clinically vulnerable phenotype, they should be interpreted as exploratory and confirmed in larger multicenter studies.