The effect of malnutrition on mortality in hospitalized patients with hematologic malignancy

Yılmaz, Merve; Atilla, Fatoş Dilan; Şahin, Fahri; Saydam, Güray

doi:10.1007/s00520-019-04952-5

Cited by 91 publications

(91 citation statements)

References 30 publications

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“…Given the relatively new nature of the GLIM criteria, there are few studies investigating the predictive ability in a cancer population. Recent studies found that malnutrition according to GLIM criteria with the addition of hand grip strength in hospitalised cancer patients is associated with higher mortality, specifically a 2-3-fold increase in mortality [38,39]. These findings are similar to our results, which confirm that the GLIM criteria are sensitive to identify mortality risk.…”

Section: Discussionsupporting

confidence: 91%

Malnutrition Screening and Assessment in the Cancer Care Ambulatory Setting: Mortality Predictability and Validity of the Patient-Generated Subjective Global Assessment Short form (PG-SGA SF) and the GLIM Criteria

et al. 2020

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Background: A valid malnutrition screening tool (MST) is essential to provide timely nutrition support in ambulatory cancer care settings. The aim of this study is to investigate the validity of the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) and the new Global Leadership Initiative on Malnutrition (GLIM) criteria as compared to the reference standard, the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: Cross-sectional observational study including 246 adult ambulatory patients with cancer receiving in-chair intravenous treatment at a cancer care centre in Australia. Anthropometrics, handgrip strength and patient descriptive data were assessed. Nutritional risk was identified using MST and PG-SGA SF, nutritional status using PG-SGA and GLIM. Sensitivity (Se), specificity (Sp), positive and negative predictive values and kappa (k) were analysed. Associations between malnutrition and 1-year mortality were investigated by Cox survival analyses. Results: A PG-SGA SF cut-off score ≥5 had the highest agreement when compared with the PG-SGA (Se: 89%, Sp: 80%, k = 0.49, moderate agreement). Malnutrition risk (PG-SGA SF ≥ 5) was 31% vs. 24% (MST). For malnutrition according to GLIM, the Se was 76% and Sp was 73% (k = 0.32, fair agreement) when compared to PG-SGA. The addition of handgrip strength to PG-SGA SF or GLIM did not improve Se, Sp or agreement. Of 100 patients who provided feedback, 97% of patients found the PG-SGA SF questions easy to understand, and 81% reported that it did not take too long to complete. PG-SGA SF ≥ 5 and severe malnutrition by GLIM were associated with 1-year mortality risk. Conclusions: The PG-SGA SF and GLIM criteria are accurate, sensitive and specific malnutrition screening and assessment tools in the ambulatory cancer care setting. The addition of handgrip strength tests did not improve the recognition of malnutrition or mortality risk.

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Section: Discussionsupporting

confidence: 91%

Malnutrition Screening and Assessment in the Cancer Care Ambulatory Setting: Mortality Predictability and Validity of the Patient-Generated Subjective Global Assessment Short form (PG-SGA SF) and the GLIM Criteria

et al. 2020

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“…The malnutrition prevalence in the VIDAsurvival cohort (52.9%), although elevated, seems to be in line with other reports from different populations using the GLIM definition of malnutrition: 64.8% in patients with oropharyngeal dysphagia after stroke, 18 35.4% among patients having gastrointestinal resections, 14 32% in patients with chronic liver disease, 19 and 25.8% in hospitalized patients with hematologic malignancy. 13 This is somewhat expected, as the literature shows a wide range of malnutrition prevalence according to the screening tools. [20][21][22][23] However, it should be highlighted that only those categorized with severe malnutrition (16.4%) were associated with increased risk of all-cause mortality.…”

Section: Discussionmentioning

confidence: 75%

“…The GLIM consensus recently provided a new approach to the diagnosis of malnutrition and called for validation studies in specific populations 5 . Indeed, some recent studies have already shown the usefulness of this instrument to predict mortality in hospitalized patients with hematologic malignancies 13 and those undergoing abdominal resections 14 . As there is no evidence yet to support the suitability of this new tool in defining malnutrition in hospitalized geriatric patients with T2DM, we carried out this study to determine whether malnutrition, according to GLIM consensus, can predict mortality in those vulnerable individuals.…”

Section: Discussionmentioning

confidence: 99%

GLIM Criteria at Hospital Admission Predict 8‐Year All‐Cause Mortality in Elderly Patients With Type 2 Diabetes Mellitus: Results From VIDA Study

Sanz-París

Martín-Palmero

Gómez-Candela

et al. 2020

J Parenter Enteral Nutr

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Background: Diabetes and older age are associated with an increased risk of malnutrition and mortality. Recently, the Global Leadership Initiative on Malnutrition (GLIM) provided a 2-step approach for the malnutrition diagnosis. In this study, we aimed to determine whether GLIM nutrition status at admission was associated with long-term survival in elderly patients with type 2 diabetes mellitus (T2DM). Additionally, we aimed to identify which GLIM criteria were more able to become prognostic indicators of early or late death. Methods: Our study included a convenience sample of 159 patients with T2DM older than 65 years and admitted to the internal medicine wards of different Spanish hospitals: the VIDA-survival cohort. Nutrition status was retrospectively assessed with the new GLIM criteria. The main outcome was long-term mortality in the cohort during an 8-year follow-up. Bivariate tables summarized the variables of interest. Kaplan-Meier survival curves and adjusted Cox regressions were also performed. Results: According to the GLIM criteria, we observed that the 35.8% and 16.3% of the VIDA-survival cohort were categorized as having moderate and severe malnutrition, respectively. Severe malnutrition was associated with increased mortality (hazard ratio [HR] = 2.09; 95% CI, 1.29-3.38), compared with nonmalnourished participants. Moderate malnutrition had a neutral effect on all-cause mortality (HR = 1.30; 95% CI, 0.88-1.92). Low plasma albumin levels, a surrogate marker of inflammation, were strongly associated with early mortality. Conclusion: Our study provides evidence that severe malnutrition according to GLIM criteria is associated with increased long-term all-cause mortality among elderly individuals with T2DM.

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“…According to the GLIM framework, 46% of patients were identified as malnourished when using combinations of two criteria. This prevalence could be apparently high as compared with previous studies which used the GLIM criteria for the diagnosis of malnutrition [5,[25][26][27]. Nevertheless, this investigation focused on a special population that presented with a high prevalence of etiologic GLIM criteria for malnutrition.…”

Section: Discussionmentioning

confidence: 85%

Comparison of Three Nutritional Screening Tools with the New Glim Criteria for Malnutrition and Association with Sarcopenia in Hospitalized Older Patients

Bellanti

Buglio

Quiete

et al. 2020

JCM

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The integrated assessment of nutritional status and presence of sarcopenia would help improve clinical outcomes of in-hospital aged patients. We compared three common nutritional screening tools with the new Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria among hospitalized older patients. To this, 152 older patients were assessed consecutively at hospital admission by the Malnutrition Universal Screening Tool (MUST), the Subjective Global Assessment (SGA), and the Nutritional Risk Screening 2002 (NRS-2002). A 46% prevalence of malnutrition was reported according to GLIM. Sensitivity was 64%, 96% and 47%, and specificity was 82%, 15% and 76% with the MUST, SGA, and NRS-2002, respectively. The concordance with GLIM criteria was 89%, 53% and 62% for the MUST, SGA, and NRS-2002, respectively. All the screening tools had a moderate value to diagnose malnutrition. Moreover, patients at high nutritional risk by MUST were more likely to present with sarcopenia than those at low risk (OR 2.5, CI 1.3-3.6). To conclude, MUST is better than SGA and NRS-2002 at detecting malnutrition in hospitalized older patients diagnosed by the new GLIM criteria. Furthermore, hospitalized older patients at high risk of malnutrition according to MUST are at high risk of presenting with sarcopenia. Nutritional status should be determined by MUST in older patients at hospital admission, followed by both GLIM and the European Working Group on Sarcopenia in Older People (EWGSOP2) assessment.

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The effect of malnutrition on mortality in hospitalized patients with hematologic malignancy

Cited by 91 publications

References 30 publications

Malnutrition Screening and Assessment in the Cancer Care Ambulatory Setting: Mortality Predictability and Validity of the Patient-Generated Subjective Global Assessment Short form (PG-SGA SF) and the GLIM Criteria

Malnutrition Screening and Assessment in the Cancer Care Ambulatory Setting: Mortality Predictability and Validity of the Patient-Generated Subjective Global Assessment Short form (PG-SGA SF) and the GLIM Criteria

GLIM Criteria at Hospital Admission Predict 8‐Year All‐Cause Mortality in Elderly Patients With Type 2 Diabetes Mellitus: Results From VIDA Study

Comparison of Three Nutritional Screening Tools with the New Glim Criteria for Malnutrition and Association with Sarcopenia in Hospitalized Older Patients

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