Impact of malnutrition diagnosed using Global Leadership Initiative on Malnutrition criteria on clinical outcomes of patients with gastric cancer

Abstract

Objective: Our objective is to validate the effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria in malnutrition diagnosis compared with Patient-Generated Subjective Global Assessment (PG-SGA) and assess the impact of malnutrition diagnosed using GLIM criteria on the clinical outcomes of patients with GC. Methods:We retrospectively analyzed the data of 895 patients who underwent radical gastrectomy at the First Affiliated Hospital of Wenzhou Medical University. Nutrition assessment was performed on all patients according to the GLIM criteria and PG-SGA.The κ statistic was used to evaluate the agreement between two methods. Multivariate logistic regression and Cox regression based on single-factor analysis were used to predict postoperative complications and overall survival rates.Results: Based on the GLIM criteria, 38.3% of the patients were diagnosed as malnourished, including 21.7% Stage I (moderate malnutrition) and 16.6% Stage II (severe malnutrition). GLIM criteria had a moderate agreement with PG-SGA (κ = 0.548).Patients in the Stage II malnutrition group had a higher incidence of complications, a longer postoperative length of stay, and higher hospitalization costs. Logistic regression showed that Stage II malnutrition was an independent risk predictor of postoperative complications (odds ratio, 3.28; 95% confidence interval [CI], 2.18-4.94). Furthermore, Cox regression analysis showed that both Stage I (hazard ratio [HR], 1.52; 95% CI, 1.11-2.07; P = .009) and Stage II (HR, 1.85; 95% CI, 1.34-2.53; P < .001) malnutrition were independent risk predictors of overall survival. Conclusion:Diagnosis of malnutrition according to the GLIM criteria is useful in predicting the adverse postoperative clinical outcomes of patients with gastric cancer.

Comparison of three malnutrition risk screening tools in identifying malnutrition according to Global Leadership Initiative on Malnutrition criteria in gastrointestinal cancer

“…According to previous studies, the prevalence of malnutrition in the gastrointestinal is about 30–50% ( 11 – 13 ). According to GLIM criteria, the prevalence of malnutrition was 28.27% in our study which is also consistent with previous studies ( 14 – 16 ).…”

Malnutrition diagnoses and associated outcomes in hospitalized patients: United States, 2018

“…[4][5][6][7]17 Multiple studies over the past year have demonstrated these links over a wide variety of patient populations, surgical and medical procedures and conditions, and malnutrition assessment tools within the last 6 months. [18][19][20][21][22][23] It is critical for malnutrition to be diagnosed in hospitalized patients so that appropriate interventions can help mitigate the risk of poor clinical outcomes.…”

Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition

“…Among the criteria included in the GLIM malnutrition diagnosis, assessment of skeletal muscle mass is, however, less commonly performed in clinical nutrition practice, and even less so in those settings that lack access to skilled clinical nutrition practitioners and to specialized body composition methods. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In addition, whereas the original GLIM guidance remained provisionally open to the inclusion of skeletal muscle function as a surrogate or proxy measure for skeletal muscle mass, 1,2 the role of muscle function both as an indicator of malnutrition and as a potential surrogate for skeletal muscle mass remains under debate. In order to further promote the use of skeletal muscle mass as an integral part of the GLIM approach for the diagnosis of malnutrition, the GLIM consortium of represen- Congress in September 2020.…”

“…[1][2][3][4] Recent research publications suggest that the GLIM approach is comparable to other longestablished nutrition assessment tools in diagnosis of malnutrition and associated risk of adverse outcomes. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The GLIM approach also offers simplicity that supports practical use by a wide variety of practitioners and healthcare professionals.…”