Validation of modified GLIM criteria to predict adverse clinical outcome and response to nutritional treatment: A secondary analysis of a randomized clinical trial

Kaegi-Braun, Nina; Boesiger, Fabienne; Tribolet, Pascal; Gomes, Filomena; Kutz, Alexander; Hoess, Claus; Pavlíček, V.; Bilz, Stefan; Sigrist, Sarah; Brändle, Michael; Henzen, Christoph; Thomann, Robert V.; Rutishauser, Jonas; Aujesky, Drahomir; Rodondi, Nicolas; Donzé, Jacques; Stanga, Zeno; Lobo, Dileep N.; Cederholm, Tommy; Müeller, Beat; Schüetz, Philipp

doi:10.1016/j.clnu.2022.02.009

Cited by 37 publications

(28 citation statements)

References 41 publications

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“…Adjusted OR for adverse clinical outcomes (including 5-year mortality) was 1.53 [95% confidence interval (95% CI) 1.22–1.93] in mGLIM-positive patients. A better response to nutritional therapy, that is reduced complications, was indicated among the mGLIM-positive compared with mGLIM-negative patients, although not consistent after interaction analyses [17 ▪▪ ].…”

Section: Resultsmentioning

confidence: 82%

Validity and feasibility of the global leadership initiative on malnutrition diagnostic concept in older people: a literature review from August 2021 to August 2022

Cederholm

Barazzoni

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewEarly 2019, the Global Leadership Initiative on Malnutrition (GLIM) concept offered a clinically applicable and objective procedure for diagnosing malnutrition. This review summarizes 40 publications from August 2021 to August 2022 that applied the GLIM criteria in older populations from various clinical settings for criterion and predictive validation. Recent findingsCriterion validity studies, by comparing the GLIM construct with various semi-gold standards such as SGA, PG-SGA, MNA-FF/SF and ESPEN criteria, indicate by sensitivity, specificity and agreement that GLIM performs at least as well as the other tools to capture malnutrition. One meta-analysis of 20 studies with various comparators reports high accuracy for distinguishing malnutrition. GLIM-malnutrition prevalence figures vary with screening tool. Predictive validity of GLIM for mortality, and other outcomes, is good in all settings reported. Sarcopenia and GLIM show some expected overlapping.

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Section: Resultsmentioning

confidence: 82%

Validity and feasibility of the global leadership initiative on malnutrition diagnostic concept in older people: a literature review from August 2021 to August 2022

Cederholm

Barazzoni

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…While several studies have validated the GLIM criteria regarding their value to identify patients at higher medical risk, there is still need for further large‐scale validation studies to understand whether these criteria are also useful for the surgical patient and whether or not they help to predict treatment response to nutrition interventions. One recent analysis using data from a randomized trial found GLIM criteria to have a high prognostic value, but patients identified as at nutrition risk who did not meet the GLIM criteria still showed some benefit from nutrition therapy 29 . Thus, this study suggests that parameters that are more specific may be needed if these criteria are used for selecting patients regarding the initiation of nutrition support interventions.…”

Section: Malnutrition: Pathogenesis Screening and Diagnostic Criteriamentioning

confidence: 79%

“…One recent analysis using data from a randomized trial found GLIM criteria to have a high prognostic value, but patients identified as at nutrition risk who did not meet the GLIM criteria still showed some benefit from nutrition therapy. 29 Thus, this study suggests that parameters that are more specific may be needed if these criteria are used for selecting patients regarding the initiation of nutrition support interventions. Also, similar to GLIM, there are other initiatives for consensus criteria regarding the diagnosis of malnutrition.…”

Section: Malnutrition: Pathogenesis Screening and Diagnostic Criteriamentioning

confidence: 97%

Nutrition issues in the general medical ward patient: From general screening to specific diagnosis and individualized treatment

Gressies

Tribolet

Schuetz

2022

J Parenter Enteral Nutr

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Disease-related malnutrition in patients in the general medical ward remains a complex syndrome, which contributes to high morbidity and mortality, and seriously interferes with recovery from acute illness. Recently, there have been important advances in the development of consensus diagnostic criteria for malnutrition, and through the recent completion of large-scale trials, the understanding of pathophysiological pathways and evidence-based treatment algorithms to provide nutrition care to patients at risk for malnutrition in the hospital setting has advanced. JOURNAL OF PARENTERAL AND ENTERAL NUTRITION | S21fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

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“…To diagnose malnutrition, one phenotypic criterion and one etiologic criterion must be present. However, while the prognostic validity of GLIM is established, it remains unclear whether these criteria can be helpful to guide treatment [ 26 ]. Herein, individual markers of muscle health may help to select patients regarding treatment [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

Association of Thoracic Skeletal Muscle Index with Clinical Outcome and Response to Nutritional Interventions in Patients at Risk of Malnutrition—Secondary Analysis of a Randomized Trial

et al. 2023

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Background: Measurement of skeletal muscle index (SMI) in computed tomography has been suggested to improve the objective assessment of muscle mass. While most studies have focused on lumbar vertebrae, we examine the association of SMI at the thoracic level with nutritional and clinical outcomes and response to nutritional intervention. Methods: We conducted a secondary analysis of EFFORT, a Swiss-wide, multicenter, randomized trial. We investigated the association of low SMI at the 12th thoracic vertebra (T12) with adverse outcome within 30 days after hospital admission (primary endpoint). Results: 663 of 2028 patients from the EFFORT trial had available CT scans for T12, and 519 among them also had available L3 scans. Mean SMI at T12 was 22.4 ± 5.8 cm2/m2 and 19.6 ± 5.5 cm2/m2 in male and female patients, respectively, and correlated well with nutritional parameters, including nutritional risk based on NRS 2002 (adjusted coefficient −0.63, 95%CI −1.25 to −0.01, p = 0.047), BMI (adjusted coefficient 0.74, 95%CI 0.66 to 0.82, p < 0.001) and handgrip strength (adjusted coefficient 0.15, 95%CI 0.11 to 0.2, p < 0.001). In multivariate regression analyses, low SMI was not a significant predictor for either clinical outcome or for treatment response. Results for SMI measured at L3 were similar, with only little prognostic value. Conclusions: Within medical patients at risk for malnutrition, SMI at thoracic vertebra provided low prognostic information regarding clinical outcomes and nutritional treatment response.

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Validation of modified GLIM criteria to predict adverse clinical outcome and response to nutritional treatment: A secondary analysis of a randomized clinical trial

Cited by 37 publications

References 41 publications

Validity and feasibility of the global leadership initiative on malnutrition diagnostic concept in older people: a literature review from August 2021 to August 2022

Validity and feasibility of the global leadership initiative on malnutrition diagnostic concept in older people: a literature review from August 2021 to August 2022

Nutrition issues in the general medical ward patient: From general screening to specific diagnosis and individualized treatment

Association of Thoracic Skeletal Muscle Index with Clinical Outcome and Response to Nutritional Interventions in Patients at Risk of Malnutrition—Secondary Analysis of a Randomized Trial

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