A scoping review on the GLIM criteria for malnutrition diagnosis: Understanding how and for which purpose it has been applied in studies on hospital settings

Milanez, Danielle Silla Jobim; Razzera, Elisa Loch; Knobloch, Ingrid da Silveira; Lima, Júlia; Bernardes, Simone; Silva, Flávia Moraes

doi:10.1016/j.clnu.2022.10.022

Cited by 11 publications

(8 citation statements)

References 111 publications

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“…This might be because at these two clinics, all patients with risk of malnutrition have an individualized nutritional plan within 24 h of admission, and often at least two oral nutritional supplements (ONS) of 300 kcal a day. Our well documented energy intake is in contrast with the findings of Jobim Milanez et al who concludes that there is unclear or unreported food intake in the majority of GLIM studies [ 30 ]. We use energy intake less than 50% compared to calculated energy needs and assimilation, both as reported in the electronic patient record.…”

Section: Discussioncontrasting

confidence: 99%

“…In the scoping review by Jobim Milanez et al . only 52% of the studies applied all five GLIM criteria when diagnosing malnutrition in hospital settings [ 30 ]. Current recommendations state that all five criteria shall be investigated when diagnosing malnutrition using GLIM [ 3 ] in the hospital setting.…”

Section: Discussionmentioning

confidence: 99%

“…Current recommendations state that all five criteria shall be investigated when diagnosing malnutrition using GLIM [ 3 ] in the hospital setting. The phenotypic criterion most often not included is reduced muscle mass, while the etiological criterion most often left out of the evaluation is energy intake [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Still, many of the patients fulfill several of the phenotypic criteria and are diagnosed with malnutrition irrespectively of the muscle mass criterion. In the hospital setting, 72% of the studies included the criterion of reduced muscle mass in diagnosing malnutrition according to GLIM, and the majority of these studies used anthropometric measures for muscle mass [ 30 ]. In our study, CC < 32/33 cm was used, while Sobestiansky et al .…”

Section: Discussionmentioning

confidence: 99%

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Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study

Enge,

Peelen,

Nielsen

et al. 2024

Eur J Nutr

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Purpose In 2019, the Global Leadership Initiative on Malnutrition (GLIM) suggested a 2-step diagnostic format for malnutrition including screening and diagnosis. Prospective validation and feasibility studies, using the complete set of the five GLIM criteria, are needed. The aims of this study were to determine the prevalence of malnutrition, and investigate how the prevalence varied with mode of screening. Furthermore, we assessed the feasibility of GLIM in geriatric patients. Methods Consecutive patients from two acute geriatric wards were included. For screening risk of malnutrition, the Mini Nutritional Assessment-Short Form (MNA-SF) or Malnutrition Screening Tool (MST) were used. In accordance with GLIM, a combination of phenotypic and etiologic criteria were required for the diagnosis of malnutrition. Feasibility was determined based on % data completeness, and above 80% completeness was considered feasible. Results One hundred patients (mean age 82 years, 58% women) were included. After screening with MNA-SF malnutrition was confirmed by GLIM in 51%, as compared with 35% after screening with MST (p = 0.039). Corresponding prevalence was 58% with no prior screening. Using hand grip strength as a supportive measure for reduced muscle mass, 69% of the patients were malnourished. Feasibility varied between 70 and 100% for the different GLIM criteria, with calf circumference as a proxy for reduced muscle mass having the lowest feasibility. Conclusion In acute geriatric patients, the prevalence of malnutrition according to GLIM varied depending on the screening tool used. In this setting, GLIM appears feasible, besides for the criterion of reduced muscle mass.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study

Enge,

Peelen,

Nielsen

et al. 2024

Eur J Nutr

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“…For the diagnosis of malnutrition based on the GLIM criteria, a nutritional risk screening is performed first, and different screening tools have been used in different cohorts. The MUST is applicable to all adults but is recommended to be used in community settings ( 75 ); the MNA is more suitable for elderly populations (≥65 years old) ( 76 ); the NRS2002 tool is applicable to adults aged 18 to 90 years, but its main role is to identify patients with nutritional risk, not to assess the existing nutritional status ( 77 ). We pooled the prevalence of malnutrition across the cohorts, and the results showed that the prevalence of malnutrition diagnosed using the MNA GLIM tool was higher than that diagnosed by the NRS2002 GLIM tool, which is consistent with the related research results reported by Xu et al ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of malnutrition based on global leadership initiative in malnutrition criteria for completeness of diagnosis and future risk of malnutrition based on current malnutrition diagnosis: systematic review and meta-analysis

Bian

Wang

et al. 2023

Front. Nutr.

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BackgroundThe proposal of the global leadership initiative in malnutrition (GLIM) criteria has received great attention from clinicians. The criteria are mainly used in the research environment and have the potential to be widely used in the clinic in the future. However, the prevalence of malnutrition and risk of future malnutrition based on a current diagnosis of malnutrition are worth exploring.MethodsA systematic search of PubMed, Embase, and the Cochrane Library was performed from the earliest available date to 1 February 2023. According to the diagnostic criteria of the GLIM, we analysed the prevalence of malnutrition by directly adopting the GLIM criteria for diagnosis without a previous nutritional risk screening (one-step approach) and by adopting the GLIM criteria for diagnosis after a nutritional risk screening (two-step approach). The main outcome was the prevalence of malnutrition based on the one-and two-step approaches. Secondary outcomes were the future risk of malnutrition based on the GLIM diagnosis, including mortality within and beyond 1 year. primary outcomes were pooled using random-effects models, and secondary outcomes are presented as hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsA total of 64 articles were included in the study, including a total of 47,654 adult hospitalized patients and 15,089 malnourished patients based on the GLIM criteria. Malnutrition was diagnosed by the one-step approach in 18 studies and by the two-step approach in 46 studies. The prevalence of malnutrition diagnosed by the one-and two-step approaches was 53% (95% CI, 42%–64%) and 39% (95% CI, 0.35%–0.43%), respectively. The prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was quite different; the prevalence of malnutrition diagnosed by the Nutritional Risk Screening 2002 (NRS2002) GLIM tool was 35% (95% CI, 29%–40%); however, the prevalence of malnutrition diagnosed by the Mini Nutrition Assessment (MNA) GLIM tool was 48% (95% CI, 35%–62%). Among the disease types, the prevalence of malnutrition in cancer patients was 44% (95% CI, 36%–52%), while that in acute and critically ill patients was 44% (95% CI, 33%–56%). The prevalence in patients in internal medicine wards was 40% (95% CI, 34%–45%), while that in patients in surgical wards was 47% (95% CI, 30%–64%). In addition, the mortality risk within 1 year (HR, 2.62; 95% CI, 1.95–3.52; I2 = 77.1%) and beyond 1 year (HR, 2.04; 95% CI, 1.70–2.45; I2 = 59.9%) of patients diagnosed with malnutrition by the GLIM criteria was double that of patients with normal nutrition.ConclusionThe prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was significantly lower than the prevalence of malnutrition diagnosed directly by the GLIM criteria. In addition, the mortality risk was significantly greater among malnourished patients assessed by the GLIM criteria.Systematic review registration: identifier CRD42023398454.

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Prospective validation of the Global Leadership Initiative on Malnutrition criteria for identifying malnutrition in hospitals: A protocol and feasibility pilot study

Roberts,

Nucera,

Dowd

et al. 2024

Nut in Clin Prac

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BackgroundThe aim of this study was to pilot a protocol for prospective validation of the Global Leadership Initiative on Malnutrition (GLIM) criteria in hospital patients and evaluate its feasibility and patient acceptability.MethodsThe validation protocol follows the GLIM consortium's rigorous methodological guidance. Protocol feasibility was assessed against criteria on recruitment (≥50%) and data collection completion (≥80%); protocol acceptability was assessed via patient satisfaction surveys and interviews. Adult inpatients in a tertiary hospital underwent four nutrition assessments (each by a different assessor); two Subjective Global Assessments (SGAs) and two GLIM assessments. All five GLIM criteria were assessed with bioelectrical impedance analysis used for muscle mass. Interrater reliability, criterion validity, and predictive validity were reported to detect trends.ResultsAll primary feasibility criteria were met (consent rate 76%; data for GLIM criterion validity collected on 83% participants). Of predictive outcome data, 100% of hospital‐related data, 82% of 6‐month mortality data, and 39% of 6‐month health‐related quality of life data were collected. The mean (SD) age of participants was 61.0 ± 16.2 years, and 51.5% were male. The median (interquartile range) length of stay and body mass index were 7 (4–15) days and 25.6 (24.2–33.0) kg/m2, respectively. GLIM criteria diagnosed 70% of the patients as malnourished vs 55% with SGA. Most patients found the data collection acceptable with minimal burden.ConclusionThe methods outlined in this rigorous GLIM validation protocol are feasible to undertake in hospitals and acceptable to patients. This paper provides practical methodological guidance for future prospective GLIM validation studies.

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A scoping review on the GLIM criteria for malnutrition diagnosis: Understanding how and for which purpose it has been applied in studies on hospital settings

Cited by 11 publications

References 111 publications

Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study

Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study

Prevalence of malnutrition based on global leadership initiative in malnutrition criteria for completeness of diagnosis and future risk of malnutrition based on current malnutrition diagnosis: systematic review and meta-analysis

Prospective validation of the Global Leadership Initiative on Malnutrition criteria for identifying malnutrition in hospitals: A protocol and feasibility pilot study

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