Involuntary Weight Loss: Diagnostic and Prognostic Significance

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Abstract
Patients (91) with involuntary weight loss were evaluated. Thirty-two (35%) had no identifiable physical cause of weight loss, whereas the remainder had various physical illnesses. During the year after the index visit, 23 (25%) of he patients died and another 14 (15%) deteriorated clinically. Physical causes of weight loss were clinically evident on the initial evaluation in 55 of 59 patients. The 4 patients in whom the diagnosis was initially missed had cancer, and in only 1 of these patients was the illness truly occult. Because diagnoses were usually made rapidly in patients with a physical cause of weight loss, it was concluded that involuntary weight loss is rarely due to occult disease. A decision rule was developed that used 6 attributes to correctly identify 57 of 59 patients (97%) with a physical cause of weight loss and 23 of 32 patients without. The rule may help in the early triage of patients with involuntary weight loss.

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