Weight loss and BMI criteria in GLIM's definition of malnutrition is associated with postoperative complications following abdominal resections – Results from a National Quality Registry

Abstract

Background & aims: Although malnutrition is thought to be common among patients with intraabdominal diseases and is recognized as a risk factor for postoperative complications, diagnostic criteria for malnutrition have not been consistent. Thus, the Global Leadership Initiative in Malnutrition (GLIM) has recently published new criteria for malnutrition. The aims of this study were to investigate the prevalence of malnutrition according to weight loss and BMI criteria in GLIM's second step for the diagnosis and their association with severe postoperative complications in patients undergoing gastrointestinal resections. Method: The current study includes adult patients who were prospectively included in the Norwegian Registry for Gastrointestinal Surgery in the period between 2015 and 2018. Exclusion criteria were acute surgery and lack of information regarding preoperative weight and/or postoperative complications. Severe surgical complications were classified according to the Revised Accordion Classification system and malnutrition with the GLIM criteria. Associations were assessed by logistic regression analyses, and the adjusted odds ratio included age (continuous), gender (male/female) and scores from the American Society of Anesthesiologists Physical Status Classification System and the Eastern Cooperative Oncology Group. Results: Out of 6110 patients, 2161 (35.4%) were classified as with malnutrition, 1206 (19.7%) with moderate and 955 (15.6%) with severe malnutrition. Malnourished patients were 1.29 (95% CI: 1.13e1.47) times more likely to develop severe surgical complications, and 2.15 (95% CI: 1.27e3.65) times more likely to die within 30 days, as compared to those who were not. Conclusion: Preoperative malnutrition is common among patients having gastrointestinal resections and is associated with an increased risk of severe surgical complications.

GLIM Criteria at Hospital Admission Predict 8‐Year All‐Cause Mortality in Elderly Patients With Type 2 Diabetes Mellitus: Results From VIDA Study

“…In addition, there are very few studies to investigate the prevalence of malnutrition in different populations using this tool. The malnutrition prevalence in the VIDA‐survival cohort (52.9%), although elevated, seems to be in line with other reports from different populations using the GLIM definition of malnutrition: 64.8% in patients with oropharyngeal dysphagia after stroke, 18 35.4% among patients having gastrointestinal resections, 14 32% in patients with chronic liver disease, 19 and 25.8% in hospitalized patients with hematologic malignancy 13 . This is somewhat expected, as the literature shows a wide range of malnutrition prevalence according to the screening tools 20–23 .…”

“…The GLIM consensus recently provided a new approach to the diagnosis of malnutrition and called for validation studies in specific populations 5 . Indeed, some recent studies have already shown the usefulness of this instrument to predict mortality in hospitalized patients with hematologic malignancies 13 and those undergoing abdominal resections 14 . As there is no evidence yet to support the suitability of this new tool in defining malnutrition in hospitalized geriatric patients with T2DM, we carried out this study to determine whether malnutrition, according to GLIM consensus, can predict mortality in those vulnerable individuals.…”

Evaluation of the Global Leadership Initiative on Malnutrition Criteria Using Different Muscle Mass Indices for Diagnosing Malnutrition and Predicting Survival in Lung Cancer Patients

“…Recently, the Global Leadership Initiative on Malnutrition (GLIM), a set of guidelines for diagnosing malnutrition, was proposed 18 . Previous studies proved the effectiveness of these guidelines in identifying malnutrition 20‐22 . However, validation of the value of the GLIM guidelines in cancer patients remains scare 23 .…”

Attitudes of Australian Patients Undergoing Treatment for Upper Gastrointestinal Cancers to Different Models of Nutrition Care Delivery: Qualitative Investigation

“…Malnutrition increases the risk of complications. These include immune impairment leading to increased risk of infection, treatment toxicity resulting in dose reductions or cessation of chemotherapy, loss of muscle mass and decreased strength, increased complications associated with surgery, more hospital admissions, longer length of stay with decreased quality of life, and increased mortality [6,9,11,12].…”