Must meet all criteria:
- Weight loss of at least 5% or more in (12) months or less in the presence of underlying illness
- At least (3) of the following conditions:
- Decreased muscle strength
- Fatigue
- Anorexia
- Low fat-free mass index
- Increased inflammatory markers
- C-reactive protein >5.0 mg/l
- IL-6 >4.0 pg/ml
- Anemia <12 g/dl
- Low serum albumin <3.2 g/dl
Supporting documentation:
- Decreased physical performance
- Dependent in all ADLs
Other guides:
Alzheimer’s/Dementia
Cancer
CHF/Heart Disease
COPD/Pulmonary Disease
CVA /Stroke/Coma
HIV/AIDS
Huntington’s Disease
Liver Disease
Neurological Diseases
ALS (Amyotrophic Lateral Sclerosis)
Parkinson’s
Muscular Dystrophy
Myasthenia Gravis
MS (Multiple Sclerosis)
Renal Failure, Chronic or Acute
Assessment Tools
Palliative Performance Scale (PPS)
New York Heart Association (NYHA) Functional Classes
Functional Assessment Staging (FAST) Scale