The association between GLIM criteria–defined malnutrition and 2‐year unplanned hospital admission in outpatients with unintentional weight loss: A retrospective cohort study

Abstract

Background This study aimed to assess malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria and Subjective Global Assessment (SGA) at baseline and determine the GLIM criteria that best predicted unplanned hospitalization in outpatients with unintentional weight loss (UWL). Methods We performed a retrospective cohort study of 257 adult outpatients with UWL. The GLIM criteria and SGA agreement were reported using the Cohen kappa coefficient. Kaplan‐Meier survival curves and adjusted Cox regression analyses were used for survival data. Logistic regression was used for the other correlation analysis. Results This study collected data from 257 patients for 2 years. Based on the GLIM criteria and SGA, malnutrition prevalence was 79.0% and 72.0%, respectively (κ = 0.728, P < 0.001). Using the SGA as a standard, GLIM had a sensitivity of 97.8%, a specificity of 69.4%, a positive predictive value of 89.2%, and a negative predictive value of 92.6%. Malnutrition was associated with higher rates of unplanned hospital admission independent of other prognostic factors (GLIM: hazard ratio [HR]=2.85, 95% CI=1.22–6.68; SGA: HR=2.07, 95% CI=1.13–3.79). Of the five GLIM criteria–related diagnostic combinations, disease burden or inflammation was the most important to predict unplanned hospital admission in multivariable analysis (HR=3.27, 95% CI=2.03–5.28). Conclusion There was good agreement between the GLIM criteria and the SGA. GLIM‐defined malnutrition, as well as all five GLIM criteria–related diagnosis combinations, had the potential to predict unplanned hospital admissions in outpatients with UWL within 2 years.

Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach

“…Because each individual must still meet a phenotypic criterion (weight loss, low BMI, or reduced muscle mass) to receive a diagnosis of malnutrition, 13–15 one cannot be diagnosed with malnutrition on the basis of meeting only an etiologic criterion. In general, the GLIM approach has had similar utility in identifying malnourished individuals and in predicting adverse outcomes as other approaches, such as SGA and AAIM 34–45 …”

Screening and assessment of malnutrition in patients with liver cirrhosis

“…Good nutritional status is graded A, moderate malnutrition is graded B, and severe malnutrition is graded C ( 65 ). One study showed that SGA-rated malnutrition was associated with increased number of unplanned hospital admissions ( 66 ). Other studies have also implicated a correlation between malnutrition and mortality in cirrhotic patients assessed by SGA ( 1 , 67 ).…”

Nutritional Risk in General Practice: Prevalence of Unintended Weight Loss; Facilitators, Barriers, and the Feasibility of an Early Patient-Involving Nutritional Intervention Among Patients With Suspected Malignant Disease

“…Malnutrition in acute and chronically ill citizens is associated with increased negative consequences for the individual patient and the society. Malnutrition has been associated with longer hospital stays, readmissions, depression, reduced quality of life, reduced physical ability, increased dependence on post-discharge care, among others [9][10][11][12][13][14][15]. These negative consequences pose a significant impact on the health economy.…”

“…Disease-related malnutrition (DRM) in acute and chronically ill citizens is associated with increased negative consequences for the individual as well as for the society due to increased economic cost [9][10][11][12][13][14][15]. DRM including nutritional risk has been investigated among inpatients and outpatients, but it is sparsely investigated in general practice among adult patients.…”