Malnutrition Prevalence according to the GLIM Criteria in Head and Neck Cancer Patients Undergoing Cancer Treatment

Abstract

Malnutrition is highly prevalent in people with head and neck cancer (HCN) and is associated with poorer outcomes. However, variation in malnutrition diagnostic criteria has made translation of the most effective interventions into practice challenging. This study aimed to determine the prevalence of malnutrition in a HNC population according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and assess inter-rater reliability and predictive validity. A secondary analysis of data available for 188 patients with HNC extracted from two cancer malnutrition point prevalence studies was conducted. A GLIM diagnosis of malnutrition was assigned when one phenotypic and one etiologic criterion were present. Phenotypic criteria were ≥5% unintentional loss of body weight, body mass index (BMI), and subjective evidence of muscle loss. Etiologic criteria were reduced food intake, and presence of metastatic disease as a proxy for inflammation. The prevalence of malnutrition was 22.6% (8.0% moderately malnourished; 13.3% severely malnourished). Inter-rater reliability was classified as excellent for the GLIM criteria overall, as well as for each individual criterion. A GLIM diagnosis of malnutrition was found to be significantly associated with BMI but was not predictive of 30 day hospital readmission. Further large, prospective cohort studies are required in this patient population to further validate the GLIM criteria.

Utilization and validation of the Global Leadership Initiative on Malnutrition (GLIM): A scoping review

“…Within healthcare system outcomes, mortality was reported most frequently (n ¼ 33; 27%) [16,22,23,25,26,28e31, 34,37e42,44,45,53,55,57,60,61,65,67,68,73e75,80,83,85,89]. Other outcomes were hospitalization/readmissions/costs (n ¼ 11; 9%) [27,29,34,38,44,62,67,69,83,85,91], hospital and/or intensive care unit LOS (n ¼ 10; 8%) [27,34,44,53,65,67,77,83,91], complications (n ¼ 7; 6%) [53e55, 68,72,85], critical care admission (n ¼ 2; 2%) [42,67], and institutionalization (n ¼ 2; 2%) [16,29]. Patient outcomes included sarcopenia (n ¼ 6; 5%) [17,18,24,35,38,93], physical function (n ¼ 5; 4%) [38,57,75,80,93], quality of life (n ¼ 5; 4%) [56,59,64,74,75], falls/fractures (n ¼ 3; 2%) [29,38], frailty (n ¼ 2; 2%)…”

Comparison of the GLIM, ESPEN and ICD-10 Criteria to Diagnose Malnutrition and Predict 30-Day Outcomes: An Observational Study in an Oncology Population

“…This study is a secondary data analysis using the collected data from two multicentre observational point prevalence studies (PPS) conducted in 2016 and 2018, with the methodology previously reported [ 21 ].…”

Malnutrition screening and diagnosis tools: Implications for practice

“…To utilize GLIM, clinicians need one criterion met from both the phenotypic and etiologic categories to adequately diagnose PCM. Researchers attempting to validate the GLIM tool in patients with head and neck cancer found that the GLIM diagnosis of PCM was significantly associated with BMI but was not predictive of 30‐day hospital readmission 36 . Efforts for the validation of GLIM are ongoing.…”