GLIM criteria for the evaluation of nutrition in palliative care patients, a comparison of MNA-SF and NRS-2002

Abstract

Aim: A new malnutrition diagnostic criterion called the Global Leadership Initiative on Malnutrition (GLIM) was created by an initiative of the same name as these criteria in 2018. The present study aims to evaluate the differences and superiority of MNA, NRS-2002 screening tests, and GLIM criteria in patients hospitalized in palliative care with a diagnosis of malnutrition. Material and Method: 148 patients who were hospitalized in palliative care due to clinical malnutrition were included in the study. MNA, NRS-2002, and GLIM screening tests were filled out by dieticians for each patient within the first 48 hours of hospitalization. Within the framework of GLIM criteria, patients were recorded for weight loss from phenotypic criteria based on information obtained from their relatives (more than five percent in the last six months or ten percent or more over the last six months). Hand dynamometer and calf circumference measurements were made to show muscle loss. Low Body Mass Index (BMI) was accepted as 20 kg/m2 for individuals under the age of 70 years, and <22 for individuals above the age of 70 years. Decreased food intake which is among the etiologic criteria was detected by calculating the mean daily consumed calories of a patient. Individuals with CRP>5 mg/L were accepted as inflammation positive. Results: Mean age in the total series was 72.98 with 70.4 in males and 75.5 in females including a total of 148 patients. Among the patients 50.67% (n=75) were males and 49.32% (n=73) were females. Malnutrition was found to be present in 141/148 (94.6%) patients according to the GLIM screening test. Malnutrition risk was present in 131/148 (87.9%) and 139/148 (93.2%) according to MNA-SF and NRS-2002, respectively. The results of the GLIM criteria and the other two screening tests were compared. While the results of the GLIM criteria and NRS-2002 test were similar, a significant difference was found between the GLIM test results and the results of MNA-SF. Conclusion:The GLIM screening test is an easy-to-use and sensitive test for the diagnosis of patients hospitalized in palliative care centers. GLIM test and NRS-2002 were found to be similar for diagnosing malnutrition. Although the results of MNA and GLIM tests were close, a significant difference was found between them in the diagnosis of malnutrition.

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“…In another study identifying the effects of enteral tube feeding (ETF) and parenteral nutrition and hydration (PNH) on survival in palliative care patients with head and neck cancer (mean age of 71.5 ± 12.1 years), 48.9% of the patients had a ≥ 50% or 500 kcal/day calorie sufficiency rate or total calorie intake on day seven 40 . In a previous study, the mean calorie intake of the patients hospitalized in palliative care was 1273 kcal/day 37 . In our study, the rate of calorie sufficiency ≥50% was 87%, and the mean required energy was 1574 kcal/day which were higher than that in the above‐mentioned studies.…”

“…40 In a previous study, the mean calorie intake of the patients hospitalized in palliative care was 1273 kcal/day. 37 In our study, the rate of calorie sufficiency ≥50% was 87%, and the mean required energy was 1574 kcal/day which were higher than that in the above-mentioned studies. Our results suggest that the success of malnutrition treatment was higher than that reported in previous studies.…”

“…The mean NRS‐2002 score was 4.7 ± 1.3, and the risk of malnutrition was 89% by NRS‐2002 in our patients. In a study comparing the differences and superiority of the mini‐nutritional assessment (MNA) and NRS‐2002 tests in palliative care patients, malnutrition risk was detected as 93.2% by NRS‐2002 37 . In another study, the increased NRS‐2002 score (mean: 4.6 ± 0.8) was significantly higher in the mortal geriatric palliative care patients than those of the discharged and intensive care patients 38 .…”

“…In a study comparing the differences and superiority of the mini-nutritional assessment (MNA) and NRS-2002 tests in palliative care patients, malnutrition risk was detected as 93.2% by NRS-2002. 37 In another study, the increased NRS-2002 score (mean: 4.6 ± 0.8) was significantly higher in the mortal geriatric palliative care patients than those of the discharged and intensive care patients. 38 In another recent study, the mean NRS-2002 score was 4.0 ± 1.0 and the rate of malnutrition risk was 93% in geriatric palliative care patients.…”