Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients

•The observed prevalence of malnutrition in the study was 26.1%, according to the subjective global assessment, whereas considering the various Global Leadership Initiative on Malnutrition combinations, the prevalence of malnutrition ranged from 3.9% to 30.0%. None of the Global Leadership Initiativ...

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Veröffentlicht in:Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2023-12, Vol.116, p.112195, Article 112195
Hauptverfasser: Ozorio, Gislaine Aparecida, Ribeiro, Lia Mara Kauchi, Santos, Bárbara Chaves, Bruzaca, Wânnia Ferreira de Sousa, Rocha, Gabriela Del Gallo Vieira da, Marchi, Luani Maria da Fonseca, Santos, Fernando Magri, Alves de Almeida, Maria Manuela Ferreira, Kulcsar, Marco Aurélio Vamondes, Junior, Ulysses Ribeiro, Correia, Maria Isabel Toulson Davisson, Waitzberg, Dan Linetzky
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container_title Nutrition (Burbank, Los Angeles County, Calif.)
container_volume 116
creator Ozorio, Gislaine Aparecida
Ribeiro, Lia Mara Kauchi
Santos, Bárbara Chaves
Bruzaca, Wânnia Ferreira de Sousa
Rocha, Gabriela Del Gallo Vieira da
Marchi, Luani Maria da Fonseca
Santos, Fernando Magri
Alves de Almeida, Maria Manuela Ferreira
Kulcsar, Marco Aurélio Vamondes
Junior, Ulysses Ribeiro
Correia, Maria Isabel Toulson Davisson
Waitzberg, Dan Linetzky
description •The observed prevalence of malnutrition in the study was 26.1%, according to the subjective global assessment, whereas considering the various Global Leadership Initiative on Malnutrition combinations, the prevalence of malnutrition ranged from 3.9% to 30.0%. None of the Global Leadership Initiative on Malnutrition combinations reached adequate concurrent validity, with the subjective global assessment as the gold standard.•Combinations that included C-reactive protein indicated a higher prevalence of malnutrition and higher sensitivity values compared with combinations with serum albumin as an etiologic criterion.•The presence of malnutrition, according to the Global Leadership Initiative on Malnutrition criteria, was an independent predictor of complications in surgical patients. The Global Leadership Initiative on Malnutrition (GLIM) criteria establish a diagnosis of malnutrition based on the presence of at least one phenotypic and one etiologic criterion. This study aimed to assess the concurrent and predictive validity of the GLIM criteria in hospitalized cancer patients. This is an observational retrospective study, including 885 cancer patients, ages >18 y, admitted to a medical oncology inpatient unit between 2019 and 2020. All patients at risk for malnutrition according to the Nutritional Risk Screening 2002 score were assessed by the subjective global assessment (SGA) and 14 different combinations of the GLIM criteria. The SGA was considered the gold standard for assessing the concurrent validity of the GLIM combinations. For a subsample of patients with data available on inflammatory markers (n = 198), the serum albumin and C-reactive protein were included in the combinations as etiologic criteria. The predictive validity of the different combinations was tested using the occurrence of surgical complications as the clinical outcome. The sensitivity and specificity values were calculated to assess the concurrent validity, univariate and multivariate logistic regression models were used to test predictive validity. Adequate concurrent and predictive validity were determined as sensitivity and specificity values >80% and odds ratio values ≥2.0, respectively. The median age of the patients was 61.0 y (interquartile range = 51.0–70.0). Head and neck cancer was the prevailing diagnosis and 375 patients were at nutritional risk. According to the SGA, 173 (26.1%) patients were malnourished (SGA categories B or C) and the prevalence of malnutrition rang
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None of the Global Leadership Initiative on Malnutrition combinations reached adequate concurrent validity, with the subjective global assessment as the gold standard.•Combinations that included C-reactive protein indicated a higher prevalence of malnutrition and higher sensitivity values compared with combinations with serum albumin as an etiologic criterion.•The presence of malnutrition, according to the Global Leadership Initiative on Malnutrition criteria, was an independent predictor of complications in surgical patients. The Global Leadership Initiative on Malnutrition (GLIM) criteria establish a diagnosis of malnutrition based on the presence of at least one phenotypic and one etiologic criterion. This study aimed to assess the concurrent and predictive validity of the GLIM criteria in hospitalized cancer patients. This is an observational retrospective study, including 885 cancer patients, ages &gt;18 y, admitted to a medical oncology inpatient unit between 2019 and 2020. 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All rights reserved.</rights><rights>2023. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-bbb5aa35c5e6cb64697ed95b3b126c99c9b9d736b0afeac611a61436f9b6ac783</citedby><cites>FETCH-LOGICAL-c414t-bbb5aa35c5e6cb64697ed95b3b126c99c9b9d736b0afeac611a61436f9b6ac783</cites><orcidid>0000-0003-1711-7347 ; 0009-0008-8481-4920 ; 0000-0002-0828-9879</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S089990072300223X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37678014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ozorio, Gislaine Aparecida</creatorcontrib><creatorcontrib>Ribeiro, Lia Mara Kauchi</creatorcontrib><creatorcontrib>Santos, Bárbara Chaves</creatorcontrib><creatorcontrib>Bruzaca, Wânnia Ferreira de Sousa</creatorcontrib><creatorcontrib>Rocha, Gabriela Del Gallo Vieira da</creatorcontrib><creatorcontrib>Marchi, Luani Maria da Fonseca</creatorcontrib><creatorcontrib>Santos, Fernando Magri</creatorcontrib><creatorcontrib>Alves de Almeida, Maria Manuela Ferreira</creatorcontrib><creatorcontrib>Kulcsar, Marco Aurélio Vamondes</creatorcontrib><creatorcontrib>Junior, Ulysses Ribeiro</creatorcontrib><creatorcontrib>Correia, Maria Isabel Toulson Davisson</creatorcontrib><creatorcontrib>Waitzberg, Dan Linetzky</creatorcontrib><title>Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients</title><title>Nutrition (Burbank, Los Angeles County, Calif.)</title><addtitle>Nutrition</addtitle><description>•The observed prevalence of malnutrition in the study was 26.1%, according to the subjective global assessment, whereas considering the various Global Leadership Initiative on Malnutrition combinations, the prevalence of malnutrition ranged from 3.9% to 30.0%. None of the Global Leadership Initiative on Malnutrition combinations reached adequate concurrent validity, with the subjective global assessment as the gold standard.•Combinations that included C-reactive protein indicated a higher prevalence of malnutrition and higher sensitivity values compared with combinations with serum albumin as an etiologic criterion.•The presence of malnutrition, according to the Global Leadership Initiative on Malnutrition criteria, was an independent predictor of complications in surgical patients. The Global Leadership Initiative on Malnutrition (GLIM) criteria establish a diagnosis of malnutrition based on the presence of at least one phenotypic and one etiologic criterion. This study aimed to assess the concurrent and predictive validity of the GLIM criteria in hospitalized cancer patients. This is an observational retrospective study, including 885 cancer patients, ages &gt;18 y, admitted to a medical oncology inpatient unit between 2019 and 2020. All patients at risk for malnutrition according to the Nutritional Risk Screening 2002 score were assessed by the subjective global assessment (SGA) and 14 different combinations of the GLIM criteria. The SGA was considered the gold standard for assessing the concurrent validity of the GLIM combinations. For a subsample of patients with data available on inflammatory markers (n = 198), the serum albumin and C-reactive protein were included in the combinations as etiologic criteria. The predictive validity of the different combinations was tested using the occurrence of surgical complications as the clinical outcome. The sensitivity and specificity values were calculated to assess the concurrent validity, univariate and multivariate logistic regression models were used to test predictive validity. Adequate concurrent and predictive validity were determined as sensitivity and specificity values &gt;80% and odds ratio values ≥2.0, respectively. The median age of the patients was 61.0 y (interquartile range = 51.0–70.0). Head and neck cancer was the prevailing diagnosis and 375 patients were at nutritional risk. According to the SGA, 173 (26.1%) patients were malnourished (SGA categories B or C) and the prevalence of malnutrition ranged from 3.9% to 30.0%, according to the GLIM combinations. None of the tested combinations reached adequate concurrent validity; however, the presence of malnutrition according to four combinations independently predicted surgical complications. The predictive validity of the GLIM was satisfactory in surgical cancer patients.</description><subject>Body mass index</subject><subject>C-reactive protein</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Clinical outcomes</subject><subject>Criteria</subject><subject>Diagnosis</subject><subject>Etiology</subject><subject>GLIM</subject><subject>Head &amp; neck cancer</subject><subject>head and neck neoplasms</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Inpatients</subject><subject>Leadership</subject><subject>Malnutrition</subject><subject>Malnutrition - complications</subject><subject>Malnutrition - diagnosis</subject><subject>Malnutrition - epidemiology</subject><subject>Medical records</subject><subject>Neoplasms - complications</subject><subject>Nutrition</subject><subject>Nutrition Assessment</subject><subject>nutrition risk assessment</subject><subject>Nutritional Status</subject><subject>odds ratio</subject><subject>Oncology</subject><subject>Patients</subject><subject>phenotype</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Serum albumin</subject><subject>Subjective global assessment</subject><subject>Surgical outcomes</subject><subject>Validity</subject><issn>0899-9007</issn><issn>1873-1244</issn><issn>1873-1244</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkUFv1DAQhS1ERZeFH8AFReLCJVtPnDgZcUJVKZUW9dKeLduZFK-y9mI7Ffx7vGzhwAFOM9J880bzHmNvgG-Ag7zYbfySNw1vxAagAeyesRUMvaihadvnbMUHxBo578_Zy5R2nHNAiS_YuehlP3BoV-zu6vthDtH5hyp_pWpJVIXpV3u9vflS2egyRaerHKrR6QcfCrDXc7lbJi74yvnKam8plu6gsyOf0yt2Nuk50eunumb3n67uLj_X29vrm8uP29q20ObaGNNpLTrbkbRGthJ7GrEzwkAjLaJFg2MvpOF6Im0lgJbQCjmhkdr2g1iz9yfdQwzfFkpZ7V2yNM_aU1iSEtC10EHH8b9oM0jRIB7dW7N3f6G7sERfHinUgFz2Anmh4ETZGFKKNKlDdHsdfyjg6piO2qnikjqmo07plJ23T8qL2dP4Z-N3HAX4cAKouPboKKpki6OWRhfJZjUG9w_5nz45nvQ</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Ozorio, Gislaine Aparecida</creator><creator>Ribeiro, Lia Mara Kauchi</creator><creator>Santos, Bárbara Chaves</creator><creator>Bruzaca, Wânnia Ferreira de Sousa</creator><creator>Rocha, Gabriela Del Gallo Vieira da</creator><creator>Marchi, Luani Maria da Fonseca</creator><creator>Santos, Fernando Magri</creator><creator>Alves de Almeida, Maria Manuela Ferreira</creator><creator>Kulcsar, Marco Aurélio Vamondes</creator><creator>Junior, Ulysses Ribeiro</creator><creator>Correia, Maria Isabel Toulson Davisson</creator><creator>Waitzberg, Dan Linetzky</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RQ</scope><scope>7RV</scope><scope>7TS</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope><orcidid>https://orcid.org/0000-0003-1711-7347</orcidid><orcidid>https://orcid.org/0009-0008-8481-4920</orcidid><orcidid>https://orcid.org/0000-0002-0828-9879</orcidid></search><sort><creationdate>202312</creationdate><title>Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients</title><author>Ozorio, Gislaine Aparecida ; Ribeiro, Lia Mara Kauchi ; Santos, Bárbara Chaves ; Bruzaca, Wânnia Ferreira de Sousa ; Rocha, Gabriela Del Gallo Vieira da ; Marchi, Luani Maria da Fonseca ; Santos, Fernando Magri ; Alves de Almeida, Maria Manuela Ferreira ; Kulcsar, Marco Aurélio Vamondes ; Junior, Ulysses Ribeiro ; Correia, Maria Isabel Toulson Davisson ; Waitzberg, Dan Linetzky</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-bbb5aa35c5e6cb64697ed95b3b126c99c9b9d736b0afeac611a61436f9b6ac783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Body mass index</topic><topic>C-reactive protein</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Clinical outcomes</topic><topic>Criteria</topic><topic>Diagnosis</topic><topic>Etiology</topic><topic>GLIM</topic><topic>Head &amp; neck cancer</topic><topic>head and neck neoplasms</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Inpatients</topic><topic>Leadership</topic><topic>Malnutrition</topic><topic>Malnutrition - complications</topic><topic>Malnutrition - diagnosis</topic><topic>Malnutrition - epidemiology</topic><topic>Medical records</topic><topic>Neoplasms - complications</topic><topic>Nutrition</topic><topic>Nutrition Assessment</topic><topic>nutrition risk assessment</topic><topic>Nutritional Status</topic><topic>odds ratio</topic><topic>Oncology</topic><topic>Patients</topic><topic>phenotype</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Serum albumin</topic><topic>Subjective global assessment</topic><topic>Surgical outcomes</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ozorio, Gislaine Aparecida</creatorcontrib><creatorcontrib>Ribeiro, Lia Mara Kauchi</creatorcontrib><creatorcontrib>Santos, Bárbara Chaves</creatorcontrib><creatorcontrib>Bruzaca, Wânnia Ferreira de Sousa</creatorcontrib><creatorcontrib>Rocha, Gabriela Del Gallo Vieira da</creatorcontrib><creatorcontrib>Marchi, Luani Maria da Fonseca</creatorcontrib><creatorcontrib>Santos, Fernando Magri</creatorcontrib><creatorcontrib>Alves de Almeida, Maria Manuela Ferreira</creatorcontrib><creatorcontrib>Kulcsar, Marco Aurélio Vamondes</creatorcontrib><creatorcontrib>Junior, Ulysses Ribeiro</creatorcontrib><creatorcontrib>Correia, Maria Isabel Toulson Davisson</creatorcontrib><creatorcontrib>Waitzberg, Dan Linetzky</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Career &amp; 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All patients at risk for malnutrition according to the Nutritional Risk Screening 2002 score were assessed by the subjective global assessment (SGA) and 14 different combinations of the GLIM criteria. The SGA was considered the gold standard for assessing the concurrent validity of the GLIM combinations. For a subsample of patients with data available on inflammatory markers (n = 198), the serum albumin and C-reactive protein were included in the combinations as etiologic criteria. The predictive validity of the different combinations was tested using the occurrence of surgical complications as the clinical outcome. The sensitivity and specificity values were calculated to assess the concurrent validity, univariate and multivariate logistic regression models were used to test predictive validity. Adequate concurrent and predictive validity were determined as sensitivity and specificity values &gt;80% and odds ratio values ≥2.0, respectively. The median age of the patients was 61.0 y (interquartile range = 51.0–70.0). Head and neck cancer was the prevailing diagnosis and 375 patients were at nutritional risk. According to the SGA, 173 (26.1%) patients were malnourished (SGA categories B or C) and the prevalence of malnutrition ranged from 3.9% to 30.0%, according to the GLIM combinations. None of the tested combinations reached adequate concurrent validity; however, the presence of malnutrition according to four combinations independently predicted surgical complications. The predictive validity of the GLIM was satisfactory in surgical cancer patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37678014</pmid><doi>10.1016/j.nut.2023.112195</doi><orcidid>https://orcid.org/0000-0003-1711-7347</orcidid><orcidid>https://orcid.org/0009-0008-8481-4920</orcidid><orcidid>https://orcid.org/0000-0002-0828-9879</orcidid></addata></record>
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1873-1244
1873-1244
language eng
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source MEDLINE; Elsevier ScienceDirect Journals
subjects Body mass index
C-reactive protein
Cancer
Chemotherapy
Clinical outcomes
Criteria
Diagnosis
Etiology
GLIM
Head & neck cancer
head and neck neoplasms
Hospitalization
Hospitals
Humans
Inflammation
Inpatients
Leadership
Malnutrition
Malnutrition - complications
Malnutrition - diagnosis
Malnutrition - epidemiology
Medical records
Neoplasms - complications
Nutrition
Nutrition Assessment
nutrition risk assessment
Nutritional Status
odds ratio
Oncology
Patients
phenotype
Regression analysis
Regression models
Retrospective Studies
Risk
Serum albumin
Subjective global assessment
Surgical outcomes
Validity
title Exploring the use of the GLIM criteria to diagnose malnutrition in cancer inpatients
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