Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (4)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Hernández, J.L.
Right arrow Articles by González-Macías, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hernández, J.L.
Right arrow Articles by González-Macías, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Q J Med 2003; 96: 649-655
© 2003 Association of Physicians

Involuntary weight loss without specific symptoms: a clinical prediction score for malignant neoplasm

J.L. Hernández, P. Matorras, J.A. Riancho and J. González-Macías

From the Department of Internal Medicine, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain

Received 24 October 2002 and in revised form 17 June 2003

Background: Involuntary weight loss (IWL) is a non-specific symptom frequently found in the setting of a malignant neoplasm. There is no established diagnostic approach for patients presenting with isolated IWL, i.e. without data suggesting a particular organ involvement or system disorder.

Aim: To assess the clinical probability of cancer in patients with isolated IWL by means of a score based on simple clinical and laboratory parameters.

Design: Retrospective analysis, followed by prospective model validation.

Methods: We analysed data from 328 patients who were treated at our Internal Medicine Department because of isolated IWL from January 1991 to December 1997. A predictive model for cancer was developed and validated. For use in clinical practice, a prediction score was derived from the regression model.

Results: There were 236 in-patients (72%) and 92 out-patients (28%). Malignancies were the most frequent cause of isolated IWL (35%), followed by psychiatric disorders (24%). Age, white blood count, and serum albumin, alkaline phosphatase, and lactate dehydrogenase levels were selected as the best predictors. The regression model discriminated relatively well between patients with or without a malignant neoplasm (area under the ROC curve 0.90, 95%CI 0.88–0.92). Model sensitivity was 69%, specificity 93% and positive likelihood ratio 9.9 (using a cut-off point of 0.5).

Discussion: We believe this to be the first study to attempt a systematic approach to the diagnosis of isolated IWL. The approach, based on very simple clinical and laboratory data, should assist the physician in a rational approach to such patients.

Address correspondence to Dr J.L. Hernández, Department of Internal Medicine, Hospital Marqués de Valdecilla, University of Cantabria, 39008 Santander, Spain. e-mail: joseluishernandez{at}ono.com


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CMAJHome page
S. M.H. Alibhai, C. Greenwood, and H. Payette
An approach to the management of unintentional weight loss in elderly people
Can. Med. Assoc. J., March 15, 2005; 172(6): 773 - 780.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
Minerva
BMJ, September 13, 2003; 327(7415): 630 - 630.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.