Power of mortality prediction in patients awaiting liver transplantation according to the Global Leadership Initiative on Malnutrition criteria and Subjective Global Assessment and Royal Free Hospital Global Assessment scores

Sousa, Francisca Isabelle da Silva e; Medeiros, Lívia Torres; Braga, Ribanna Aparecida Marques; Daltro, Ana Filomena Camacho Santos; Maia, Carla Soraya Costa

doi:10.1016/j.nut.2022.111889

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…33 The GLIM criteria, compared to the SGA had the best predictability power identifying mortality in patients on the waiting list and 12 months after transplant. 39 A study using the SGA, found that severely malnourished patients died in 8 months post-transplant compared to 20 months in their non-malnourished counterparts. 36 In liver transplant candidates with cirrhosis, sarcopenia is associated with mortality on the waiting list, especially for those with lower Model for End Stage Liver Disease (MELD) scores.…”

Section: Liver Cirrhosismentioning

confidence: 99%

“…According to research using the GLIM criteria, patients with liver cirrhosis and malnutrition are at an estimated 3.79 times greater risk for mortality while on the transplant waiting list and 12 months after transplant compared to well‐nourished patients ( p = .042) 33 . The GLIM criteria, compared to the SGA had the best predictability power identifying mortality in patients on the waiting list and 12 months after transplant 39 . A study using the SGA, found that severely malnourished patients died in 8 months post‐transplant compared to 20 months in their non‐malnourished counterparts 36 …”

Section: Abdominal Organ Transplant Candidatesmentioning

confidence: 99%

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Malnutrition in solid organ transplant patients: A review of the literature

Lorden,

Engelken,

Sprang

et al. 2023

Clinical Transplantation

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Screening for malnutrition is of vital importance for solid organ transplant candidates to optimize nutrition status before transplant, to improve clinical outcomes and to inform selection committees of nutritional contraindications and risks. There are multiple criteria and screening tools available for determining malnutrition diagnosis and risk. Registered Dietitian Nutritionists use these tools for nutrition assessments to quantify the severity of malnutrition, provide patient‐centered interventions, and monitor progression. Many transplant centers in the United States utilize the American Society of Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics’ Adult Malnutrition Criteria, though there is limited research using these criteria specifically in the transplant population. Malnutrition, utilizing other diagnostic and screening tools, has been associated with important complications, including longer length of hospital stay, increased mortality, decreased quality of life, worsened end‐stage organ progression, and decreased functional status. Malnutrition typically results from sarcopenia and cachexia, and can ultimately lead to frailty, causing further negative impacts on transplant outcomes. This literature review summarizes the current research on malnutrition in solid organ transplant candidates and provides recommendations for future research and current practice implications.

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Section: Liver Cirrhosismentioning

confidence: 99%

Section: Abdominal Organ Transplant Candidatesmentioning

confidence: 99%

Malnutrition in solid organ transplant patients: A review of the literature

Lorden,

Engelken,

Sprang

et al. 2023

Clinical Transplantation

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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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Estado nutricional e avaliação do global leadership initiative on malnutrition em pacientes com doença hepática crônica acompanhados em um hospital escola

Miranda,

Silva,

Moreira

et al. 2024

Cad. Pedagógico

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Introdução: A descompensação da doença hepática está diretamente relacionada ao desenvolvimento da desnutrição. O Global Leadership Initiative On Malnutrition, publicou um instrumento que fornece critérios para diagnosticar a desnutrição, sendo composto por critérios fenotípicos e etiológicos. Objetivo: Avaliar o estado nutricional e aplicar o GLIM em pacientes com doença hepática crônica, acompanhados em um hospital escola do Recife. Metodologia: O estudo possui delineamento transversal de caráter analítico, realizado entre março e setembro de 2023. A seleção da amostra foi por conveniência, conforme os critérios de inclusão: pacientes portadores de doença hepática de qualquer origem etiológica, com idade igual ou superior a 18 anos, atendidos no ambulatório de hepatologia do Instituto de Medicina Integral Prof. Fernando Figueira, localizado no Recife-PE. Foram coletados dados demográficos, socioeconômicos, clínicos, estilo de vida e bioquímicos. Para avaliação antropométrica foram utilizados: peso, altura, índice de massa corporal, circunferência do braço, circunferência da panturrilha, dobra cutânea tricipital, circunferência muscular do braço, área muscular do braço e a força de preensão palmar. A desnutrição foi avaliada por meio dos critérios GLIM, sendo necessário apenas um critério fenotípico e um critério etiológico para a classificação. A pesquisa foi aprovada pelo Comitê de Ética e Pesquisa da instituição proponente do estudo, obtendo o número do CAAE: 66743423.6.0000.5201. Resultados: A amostra foi composta por 98 pacientes, com média de idade de 50,11 ± 16,26 anos, sendo 66,3% mulheres. Dentre as etiologias, 31,3% possuíam álcool e doença hepática gordurosa não alcoólica. Quanto a avaliação nutricional, 60,8% foram classificados com obesidade de acordo com o IMC. Quando comparado as médias das variáveis antropométricas com a ferramenta GLIM, o peso (p=0,008), IMC (p <0,001), CB (p=0,001) e DCT (p <0,001) apresentaram associação significativa. Além disso foi verificado que 46,5% e 40% dos indivíduos com eutrofia e obesidade conforme a CB e DCT eram desnutridos de acordo com o GLIM, com p-valor significativo (p=0,008 e p=0,006), respectivamente. Conclusão: O GLIM foi bom preditor para diagnosticar a desnutrição em pacientes com doenças hepáticas crônicas, possibilitando no diagnóstico nutricional mais fidedigno, corroborando no planejamento da conduta dietoterápica mais efetiva e em desfechos positivos.

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Power of mortality prediction in patients awaiting liver transplantation according to the Global Leadership Initiative on Malnutrition criteria and Subjective Global Assessment and Royal Free Hospital Global Assessment scores

Cited by 3 publications

References 32 publications

Malnutrition in solid organ transplant patients: A review of the literature

Malnutrition in solid organ transplant patients: A review of the literature

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

Estado nutricional e avaliação do global leadership initiative on malnutrition em pacientes com doença hepática crônica acompanhados em um hospital escola

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