Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients.

Autor: Ozorio GA; Nutrition and Dietetics Service, Cancer Institute of the State of São Paulo, São Paulo, Brazil. Electronic address: gislaineozorio@gmail.com., Ribeiro LMK; Nutrition and Dietetics Service, Cancer Institute of the State of São Paulo, São Paulo, Brazil., Santos BC; Graduate Program in Food Science, Federal University of Minas Gerais, Minas Gerais, Brazil., Bruzaca WFS; Multiprofessional Residency Program in Adult Oncology Care, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Rocha GDGVD; Multiprofessional Residency Program in Adult Oncology Care, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Marchi LMDF; Multiprofessional Residency Program in Adult Oncology Care, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Santos FM; Multiprofessional Residency Program in Adult Oncology Care, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Alves de Almeida MMF; Nutrition and Dietetics Service, Cancer Institute of the State of São Paulo, São Paulo, Brazil., Kulcsar MAV; Department of Head and Neck Surgery, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil., Junior UR; Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil., Correia MITD; Graduate Program in Surgery, Federal University of Minas Gerais, Minas Gerais, Brazil., Waitzberg DL; Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Nutrition (Burbank, Los Angeles County, Calif.) [Nutrition] 2023 Dec; Vol. 116, pp. 112195. Date of Electronic Publication: 2023 Aug 16.
DOI: 10.1016/j.nut.2023.112195
Abstrakt: Objectives: The Global Leadership Initiative on Malnutrition (GLIM) criteria establish a diagnosis of malnutrition based on the presence of at least one phenotypic and one etiologic criterion. This study aimed to assess the concurrent and predictive validity of the GLIM criteria in hospitalized cancer patients.
Methods: This is an observational retrospective study, including 885 cancer patients, ages >18 y, admitted to a medical oncology inpatient unit between 2019 and 2020. All patients at risk for malnutrition according to the Nutritional Risk Screening 2002 score were assessed by the subjective global assessment (SGA) and 14 different combinations of the GLIM criteria. The SGA was considered the gold standard for assessing the concurrent validity of the GLIM combinations. For a subsample of patients with data available on inflammatory markers (n = 198), the serum albumin and C-reactive protein were included in the combinations as etiologic criteria. The predictive validity of the different combinations was tested using the occurrence of surgical complications as the clinical outcome. The sensitivity and specificity values were calculated to assess the concurrent validity, univariate and multivariate logistic regression models were used to test predictive validity. Adequate concurrent and predictive validity were determined as sensitivity and specificity values >80% and odds ratio values ≥2.0, respectively.
Results: The median age of the patients was 61.0 y (interquartile range = 51.0-70.0). Head and neck cancer was the prevailing diagnosis and 375 patients were at nutritional risk. According to the SGA, 173 (26.1%) patients were malnourished (SGA categories B or C) and the prevalence of malnutrition ranged from 3.9% to 30.0%, according to the GLIM combinations. None of the tested combinations reached adequate concurrent validity; however, the presence of malnutrition according to four combinations independently predicted surgical complications.
Conclusions: The predictive validity of the GLIM was satisfactory in surgical cancer patients.
Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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