Prevalence of malnutrition diagnosed by the Global Leadership Initiative on Malnutrition and Mini Nutritional Assessment in older adult outpatients and comparison between the Global Leadership Initiative on Malnutrition and Mini Nutritional Assessment energy‐protein intake: A cross‐sectional study

Özer, Nurhayat Tuğra; Akın, Sibel; Şahįn, Gülşah; Şahin, Serap

doi:10.1002/jpen.2123

Cited by 12 publications

(11 citation statements)

References 49 publications

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“…As malnutrition is difficult to clinically diagnose, it may be underreported and therefore underrepresented in our sample size. Furthermore, malnutrition is often diagnosed either by physical exam or laboratory assessment; however, multiple diagnostic tools also exist to arrive at this diagnosis [13,22,23]. Despite this, the NIS database does not allow for the stratification of nutritional status due to its coding structure.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition Imparts Worse Outcomes in Patients With Diverticulitis: A Nationwide Inpatient Sample Database Study

Shaikh¹,

Khrais²,

Le³

et al. 2022

Cureus

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IntroductionStudies show that malnutrition can lead to worsening morbidity and mortality in patients. However, to our knowledge, no large database study has been conducted describing the effects of malnutrition in patients with diverticulitis. In this article, we aim to assess the impact of pre-existing malnutrition on outcomes of patients admitted for diverticulitis. MethodsData between 2008 and 2014 from the Nationwide Inpatient Sample database were extracted. Inclusion criteria for both groups included patients with a primary diagnosis of diverticulitis using the International Classification of Diseases, Ninth Revision codes. Exclusion criteria included all patients less than 18 years of age. The test group consisted of patients with a primary diagnosis of diverticulitis and a concurrent diagnosis of malnutrition. In-hospital mortality, length of stay, total cost, and complications, including various forms of sepsis, perforation, bleeding, and GI bleeding, were compared between the two groups. Univariate and multivariate analyses were used to generate odds ratios. Multivariate analysis included age, sex, race, income quartile, and calculated Elixhauser scores. Elixhauser comorbidity scores predicting mortality and readmission were calculated based on weighted scores from 29 different comorbidities. Scores were compared between the two groups using univariate analysis. ResultsThere were a total of 1,520,919 patients in the study, of which 427,679 (2.8%) had a pre-existing diagnosis of malnutrition. On univariate analysis, there was a significant increase in mortality in patients with malnutrition (OR: 10.2, p < 0.01). Additionally, patients with malnutrition appeared to have longer lengths of stay (mean: 12.9, p < 0.01) and greater cost of hospitalization (mean: 194436.82, p < 0.01). Patients with malnutrition had greater rates of sepsis events (OR: 12.0, p < 0.01), perforation (OR: 2.8, p < 0.01), and GI bleed (OR: 1.84, p < 0.01). On multivariate analysis, malnutrition appeared to significantly increase mortality (OR: 3.3, p < 0.01). DiscussionPatients who present with diverticulitis with malnutrition appear to have significantly worse outcomes. We hypothesize that malnutrition leads to a shift in the gut microbiota, resulting in increased inflammation. As a result, these patients may have an increased risk of worse outcomes, such as sepsis and death. Addressing nutrition in patients with diverticulosis or those with a history of diverticulitis may improve outcomes.

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Section: Discussionmentioning

confidence: 99%

Malnutrition Imparts Worse Outcomes in Patients With Diverticulitis: A Nationwide Inpatient Sample Database Study

Shaikh¹,

Khrais²,

Le³

et al. 2022

Cureus

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“…Among the criteria included in the GLIM malnutrition diagnosis, assessment of skeletal muscle mass is, however, less commonly performed in clinical nutrition practice, and even less so in those settings that lack access to skilled clinical nutrition practitioners and to specialized body composition methods. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In addition, whereas the original GLIM guidance remained provisionally open to the inclusion of skeletal muscle function as a surrogate or proxy measure for skeletal muscle mass, 1,2 the role of muscle function both as an indicator of malnutrition and as a potential surrogate for skeletal muscle mass remains under debate. In order to further promote the use of skeletal muscle mass as an integral part of the GLIM approach for the diagnosis of malnutrition, the GLIM consortium of represen- Congress in September 2020.…”

Section: Introductionmentioning

confidence: 99%

“…After publication in 2019, the GLIM criteria for malnutrition diagnosis have been embraced by many in the clinical nutrition community, and their utilization in clinical practice is growing 1–4 . Recent research publications suggest that the GLIM approach is comparable to other long‐established nutrition assessment tools in diagnosis of malnutrition and associated risk of adverse outcomes 5–21 . The GLIM approach also offers simplicity that supports practical use by a wide variety of practitioners and healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] Recent research publications suggest that the GLIM approach is comparable to other longestablished nutrition assessment tools in diagnosis of malnutrition and associated risk of adverse outcomes. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The GLIM approach also offers simplicity that supports practical use by a wide variety of practitioners and healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

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Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition

Compher

Cederholm

Correia

et al. 2022

J Parenter Enteral Nutr

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The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus‐based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual‐energy x‐ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic‐ and sex‐specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.

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“…15 Studies have tested the validity of the diagnostic tool, GLIM, against different screening tools, including the Malnutrition Universal Screening Tool, SGA, MNA-SF, and NRS-2002. [15][16][17][18][19] However, data on the validity and reliability of different diagnostic tools are scarce across multiple settings, age groups, and medical diagnoses. 15,[18][19][20][21][22][23] Additionally, only a few studies utilized two or more of the diagnostic tools (AND/ASPEN, ESPEN, and GLIM).…”

Section: Introductionmentioning

confidence: 99%

AND/ASPEN and the GLIM malnutrition diagnostic criteria have a high degree of criterion validity and reliability for the identification of malnutrition in a hospital setting: A single‐center prospective study

Chaar

Mattar

Khoury

2022

J Parenter Enteral Nutr

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Background: Multiple malnutrition diagnostic tools are available in clinical practice, yet, evidence on their validity and reliability is limited. We aim to assess and compare the validity and reliability of the different combinations of indicators of the three most used diagnostic tools with two validated malnutrition screening tools. Methods: Nutrition risk screening was evaluated using the Mini Nutritional Assessment-Short Form (MNA-SF) and the Nutrition Risk Screening-2002 (NRS-2002). Nutrition assessment was conducted using different combinations of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN), the European Society for Clinical Nutrition and Metabolism (ESPEN), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Concurrent criterion validity and inter-rater reliability of the overall and the different combinations of indicators in the diagnostic tools were evaluated and compared. Sensitivity, specificity, positive predictive value, negative predictive value, and Cohen kappa were calculated to determine tool validity and reliability. Results: The AND/ASPEN (132 [22.8%]) combination and GLIM-1 (133 [23.0%])(weight loss + compromised food intake) predicted the highest number of malnourished patients and reported a high degree of concurrent criterion validity, agreement, and reliability. On the contrary, overall ESPEN (using any combination) and GLIM-2 (reduced body mass index [BMI] + compromised food intake) reported only moderate criterion validity and low agreement and reliability. Conclusion:Different combinations of diagnostic criteria led to varying validity and reliability, with the lowest validation results rising from the combinations of indicators using BMI as a criterion for malnutrition diagnosis.

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Cited by 12 publications

References 49 publications

Malnutrition Imparts Worse Outcomes in Patients With Diverticulitis: A Nationwide Inpatient Sample Database Study

Malnutrition Imparts Worse Outcomes in Patients With Diverticulitis: A Nationwide Inpatient Sample Database Study

Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition

AND/ASPEN and the GLIM malnutrition diagnostic criteria have a high degree of criterion validity and reliability for the identification of malnutrition in a hospital setting: A single‐center prospective study

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