Abstract
Background: Malnutrition is prevalent among patients with cancer. The Global Leadership Initiative on Malnutrition (GLIM) released new universal criteria for diagnosing malnutrition in 2019. The objectives of this study were to assess the prevalence of malnutrition in patients with cancer using the GLIM criteria, explore the correlation between the GLIM criteria, and clinical outcomes, and compare the GLIM criteria with subjective global assessment (SGA).Methods: This retrospective analysis was conducted on 2,388 patients with cancer enrolled in a multicenter study. Nutritional risk was screened using the Nutritional Risk Screening-2002, and the nutritional status was assessed using SGA and GLIM criteria. Chi-square analysis and Wilcoxon rank sum test, stratified by age 65 years, were used to evaluate the effect of GLIM-defined malnutrition on clinical outcomes. Logistic regression analysis was used to analyze the nutritional status and complications, and the interrater reliability was measured using a kappa test.Results: The prevalence of malnutrition defined by the GLIM criteria was 38.9% (929/2,388). GLIM-defined malnutrition was significantly associated with in-hospital mortality (P = 0.001) and length of hospital stays (P = 0.001). Multivariate logistic regression analysis showed GLIM-defined malnutrition significantly increased complications (odds ratio [OR] 1.716, 95% CI 1.227–2.400, P = 0.002). The GLIM criteria had a “moderate agreement” (kappa = 0.426) compared with the SGA.Conclusions: The prevalence of malnutrition in hospitalized patients with cancer is high, and malnourishment in patients with cancer is associated with poorer clinical outcomes. The use of the GLIM criteria in assessing the nutritional status of inpatients with cancer is recommended and can be used as the basis for nutritional interventions.
Highlights
Malnutrition is a state resulting from a lack of intake or uptake of nutrition that leads to altered body composition and body cell mass, which in turn lead to diminished physical and mental function and impaired clinical outcome from disease [1]
This study aimed to assess the prevalence of malnutrition in patients with cancer using the Global Leadership Initiative on Malnutrition (GLIM) criteria, explore the correlation between the GLIM criteria, and clinical outcomes, such as complication rate, and compare the GLIM criteria with subjective global assessment (SGA)
The prevalence of malnutrition based on GLIM criteria at admission in patients with cancer was 38.9% (929/2,388), including 27.0% (644/2,388) with moderate malnutrition and 11.9% (285/2,388) with severe malnutrition
Summary
Malnutrition is a state resulting from a lack of intake or uptake of nutrition that leads to altered body composition (decreased fatfree mass) and body cell mass, which in turn lead to diminished physical and mental function and impaired clinical outcome from disease [1]. Studies have revealed that individualized nutritional support reduces the risk of mortality and improves the function and quality of life among the patients with cancer with higher nutritional risk, relative to when they were provided only with hospital nutrition [8]. The Global Leadership Initiative on Malnutrition (GLIM) developed and reported new diagnostic criteria for malnutrition in clinical settings [11]. The GLIM criteria still lack validation to diagnose malnutrition in hospitalized patients with cancer, and no study to date has comprehensively analyzed the inpatient clinical outcomes of patients with cancer using the GLIM criteria. The Global Leadership Initiative on Malnutrition (GLIM) released new universal criteria for diagnosing malnutrition in 2019. The objectives of this study were to assess the prevalence of malnutrition in patients with cancer using the GLIM criteria, explore the correlation between the GLIM criteria, and clinical outcomes, and compare the GLIM criteria with subjective global assessment (SGA)
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