Studi Komparasi Kriteria Global Leadership Initiative on Malnutrition (Glim) Dengan Subjective Global Assesment (Sga) Dalam Mendiagnosis Malnutrisi Pada Pasien Rawat Inap Di Bangsal Penyakit Dalam Rsupn Dr. Cipto Mangunkusumo

Abstract

Malnutrition in hospitalized patients is a global problem with an increasing prevalence. To date, there is no universally accepted consensus for diagnosing malnutrition. Comparative studies between malnutrition criteria according to GLIM and the gold standard, namely Subjective Global Assessment (SGA) have not been widely carried out in Indonesia. This study aims to compare the validity of the GLIM criteria against the SGA. The study design was cross-sectional with the subject of hospitalized internal medicine patients aged 18-45 years (n=108). The assessment was conducted by comparing prevalence, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), the area under the curve (AUC), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) GLIM criteria against SGA. The results obtained in this study were 57.4 percent women, 60.2 percent late adulthood, 54.6 percent high school graduates, 34.3 percent private employees, and 68.5 percent have income less than minimum wage. The prevalence of malnutrition based on GLIM criteria and SGA was 75 percent and 70.4 percent, respectively. The GLIM criteria have good validity (sensitivity of 98.7%, specificity 81.3%, PPV 92.5%, NPV 96.2%, AUC value 0,9, LR+ 5.28 and a LR- 0.016). Based on the results of the study, it can be concluded that the GLIM criteria have good validity, so they can be recommended as diagnostic tools to determine malnutrition status in hospital nutrition services

Malnutrition at Hospital Admission and Its Associated Factors in Internal Medicine Inpatients

“…Moreover, the wide prevalence range might be due to different research methodologies and mixed populations. A greater malnutrition proportion at admission in present study has been confirmed by previous findings (GLIM 75% vs. SGA 70.4 %) [34], and supported by Syam et al with malnutrition rate according to SGA have reached 65,5% among non-surgical inpatients [33]. This could be explained by the use of the GLIM which has 2 measurable criteria as the latest validated diagnosis tools which proved has better performance than previous methods in validity, and accuracy in predicting negative clinical outcomes [28,[30][31][32].…”

“…Specifically in Indonesia, undernourishment was observed in 26.7-65.5% of adult internal medicine inpatients. (6,24,33) This number has recently tended to be higher when assessed using the GLIM criteria (75.0%) than the SGA (70.4%) [34]. However, the risk factors for malnutrition based on GLIM criteria have not been examined, particularly among inpatients in Indonesia, which has a large population with the highest mortality caused by comorbidity, namely stroke, ischaemic heart disease, diabetes mellitus, lung disease and liver disease [35].…”