GLIM Criteria Research Articles

STUDI KOMPARASI KRITERIA GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION (GLIM) DENGAN SUBJECTIVE GLOBAL ASSESMENT (SGA) DALAM MENDIAGNOSIS MALNUTRISI PADA PASIEN RAWAT INAP DI BANGSAL PENYAKIT DALAM RSUPN DR. CIPTO MANGUNKUSUMO

Malnutrition in hospitalized patients is a global problem with an increasing prevalence. To date, there is no universally accepted consensus for diagnosing malnutrition. Comparative studies between malnutrition criteria according to GLIM and the gold standard, namely Subjective Global Assessment (SGA) have not been widely carried out in Indonesia. This study aims to compare the validity of the GLIM criteria against the SGA. The study design was cross-sectional with the subject of hospitalized internal medicine patients aged 18-45 years (n=108). The assessment was conducted by comparing prevalence, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), the area under the curve (AUC), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) GLIM criteria against SGA. The results obtained in this study were 57.4 percent women, 60.2 percent late adulthood, 54.6 percent high school graduates, 34.3 percent private employees, and 68.5 percent have income less than minimum wage. The prevalence of malnutrition based on GLIM criteria and SGA was 75 percent and 70.4 percent, respectively. The GLIM criteria have good validity (sensitivity of 98.7%, specificity 81.3%, PPV 92.5%, NPV 96.2%, AUC value 0,9, LR+ 5.28 and a LR- 0.016). Based on the results of the study, it can be concluded that the GLIM criteria have good validity, so they can be recommended as diagnostic tools to determine malnutrition status in hospital nutrition services

A Comparative Study between the Three Waves of the Pandemic on the Prevalence of Oropharyngeal Dysphagia and Malnutrition among Hospitalized Patients with COVID-19.

Background: The phenotype of patients affected by COVID-19 disease changed between the waves of the pandemic. We assessed the prevalence of oropharyngeal dysphagia (OD), malnutrition (MN), and mortality between the first three waves of COVID-19 patients in a general hospital. Methods: a prospective observational study between April 2020–May 2021. Clinical assessment for OD was made with the volume-viscosity swallowing test; nutritional assessment was performed consistent with GLIM criteria. A multimodal intervention was implemented in the second and third wave, including (a) texturized diets—fork mashable (1900 kcal + 90 g protein) or pureed (1700 kcal + 75 g protein), (b) oral nutritional supplements (500–600 kcal + 25–30 g protein), and (c) fluid thickening (250 mPa·s or 800 mPa·s). Results: We included 205 patients (69.3 ± 17.6 years) in the 1st, 200 (66.4 ± 17.5 years) in the 2nd, and 200 (72.0 ± 16.3 years;) in the 3rd wave (p = 0.004). On admission, prevalence of OD was 51.7%, 31.3% and 35.1%, and MN, 45.9%, 36.8% and 34.7%, respectively; mortality was 10.7%, 13.6% and 19.1%. OD was independently associated with age, delirium, and MN; MN, with age, OD, diarrhea and ICU admission; mortality, with age, OD and MN. (4) Conclusions: Prevalence of OD, MN and mortality was very high among COVID-19 patients. OD was independently associated with MN and mortality. An early and proactive multimodal nutritional intervention improved patients’ nutritional status.

Diagnosis of Malnutrition According to GLIM Criteria Predicts Complications and 6-Month Survival in Cancer Outpatients.

Background and Aims: Malnutrition is a condition that has a great impact on oncology patients. Poor nutritional status is often associated with increased morbidity and mortality, increased toxicity, and reduced tolerance to chemotherapy, among other complications. The recently developed GLIM criteria for malnutrition aim to homogenize its diagnosis, considering the baseline disease status. We aimed to evaluate the performance of these new criteria for the prediction of complications and mortality in patients with cancer. Methods: This work is a prospective, single-center study. All outpatients under active treatment for head and neck, upper gastrointestinal, and colorectal tumors between February and October 2020 were recruited. These patients were followed up for 6 months, assessing the occurrence of complications and survival based on GLIM diagnoses of malnutrition. Results: We enrolled 165 outpatients, 46.66% of whom were malnourished. During the 6-month follow-ups, patients with malnutrition (46.7%, according to GLIM criteria) had a ~3-fold increased risk of hospital admission (p < 0.001) and occurrence of severe infection (considered as those requiring hospitalization, intravenous antibiotics, and/or drainage by interventional procedures) (p = 0.002). Similarly, malnourished patients had a 3.5-fold increased risk of poor pain control and a 4.4-fold increased need for higher doses of opioids (both p < 0.001). They also had a 2.6-fold increased risk of toxicity (p = 0.044) and a 2.5-fold increased likelihood of needing a dose decrease or discontinuation of cancer treatment (p = 0.011). The 6-month survival of malnourished patients was significantly lower (p = 0.023) than in non-malnourished patients. Conclusions: Diagnoses of malnutrition according to the GLIM criteria in oncology patients undergoing active treatment predict increased complications and worse survival at 6-month follow-ups, making them a useful tool for assessing the nutritional status of oncology patients.

Protocolo diagnóstico y manejo de la desnutrición en el paciente mayor

Malnutrition in older patients is common and associated with various complications, including morbidity and mortality, hospitalizations, readmissions, and an increase in healthcare costs. However, it tends to be underdiagnosed. Prevention, diagnosis, and an early treatment approach are key in order to avoid complications. All older patients should be assessed in terms of nutrition by means of a validated scale such as the Mini Nutritional Assessment-Short Form and, in the event of a positive screening, the study should be confirmed with a scaled assessment that includes the GLIM criteria as a malnutrition diagnostic tool. In addition, an individualized treatment plan that will be periodically re-evaluated must be created for all patients at risk of malnutrition or who are malnourished.

Evaluation of malnutrition in patients undergoing major abdominal surgery using GLIM criteria and comparing CT and BIA for muscle mass measurement.

GLIM criteria have become a worldwide standard for diagnosing malnutrition. They emphasize the measurement of muscle mass but do not provide clear recommendations for the use of different diagnostic tools and cut-offs. Measurements of body composition by using computerized tomography (CT) and bioelectrical impedance analysis (BIA) are both easily accessible in hospitalized patients. However, there is sparse data regarding the comparison for GLIM diagnosis of malnutrition and its prognostic impact for postoperative outcome in patients undergoing major abdominal surgery for cancer. We retrospectively analysed 260 patients undergoing major abdominal surgery between January 2017 and December 2019. Patients were prospectively screened and assessed for malnutrition with Nutritional Risk Score (NRS) and Subjective Global assessment (SGA). Body composition was analysed with CT scan and BIA within 30 days before surgery. GLIM criteria were retrospectively determined referring to the Fat free Mass from BIA (FFMBIA) and Muscle Mass from axial CT scan at lumbar level 3 (MMCT). The prevalence of GLIM - malnutrition according to BIA and CT was evaluated. Multivariate logistic regression analysis was used to determine association between malnutrition and outcome parameters. ROC-curves specified sensitivity and specificity of the different tools and areas under the curve were calculated. From 260 patients in total, 179 patients (68.8%) had a confirmed malnutrition according to MMCT, 178 patients (68.5%) were malnourished according to SGA (grade B or C), whereas 66 patients (25.4%) were diagnosed with malnutrition using FFMBIA. The risk for developing a complication was significant associated with both methods, FFMBIA (OR 2.116, 95% CI 1.185-3.778, p=0.01) and MMCT (OR 2.028, 95% CI 1..188-3.463, p=0.009). Sensitivity for the prediction of overall complications was: MMCT 76.3%, FFMBIA 31.9%, and SGA 73.3%; specificity: MMCT 40.0%, FFMBIA 81.6%, and SGA 36.8%. When using GLIM criteria, the method for measuring muscle mass is pivotal resulting in considerable differences in prevalence, sensitivity, and specificity. GLIM criteria are predictive for the risk of developing complications in patients undergoing major abdominal surgery. With the pre-existing cut-offs, BIA seems to diagnose patients at an more advanced stage of malnutrition and indicates an advanced deterioration of nutritional status.

Machine Learning-Based Prediction of In-Hospital Complications in Elderly Patients Using GLIM-, SGA-, and ESPEN 2015-Diagnosed Malnutrition as a Factor.

Background: Malnutrition is prevalent in elderly inpatients and is associated with various adverse outcomes during their hospital stay, but the diagnosis of malnutrition still lacks widely applicable criteria. This study aimed to investigate the association of malnutrition diagnosed with the SGA, ESPEN 2015, and GLIM criteria, respectively, with in-hospital complications in elderly patients. Method: Hospitalized patients over 65 years old who had been assessed with the SGA guideline for malnutrition at admission were retrospectively recruited from a large observational cohort study conducted in 34 level-A tertiary hospitals in 18 cities in China from June to September 2014. Malnutrition was then retrospectively diagnosed using the GLIM and ESPEN 2015 criteria, respectively, for comparison with the results of the SGA scale. The risk factors for malnutrition were analyzed using logistic regression, and the value of the three diagnostic criteria in predicting the in-hospital complications was subsequently explored using multivariate regression and the random forest machine learning algorithm. Results: A total of 2526 subjects who met the inclusion and exclusion criteria of the study were selected from the 7122 patients in the dataset, with an average age of 74.63 ± 7.12 years, 59.2% male, and 94.2% married. According to the GLIM, SGA, and ESPEN 2015 criteria, the detection rates of malnutrition were 37.8% (956 subjects), 32.8% (829 subjects), and 17.0% (429 subjects), respectively. The diagnostic consistency between the GLIM and the SGA criteria is better than that between the ESPEN 2015 and the SGA criteria (Kappa statistics, 0.890 vs. 0.590). Logistic regression showed that the risk of developing complications in the GLIM-defined malnutrition patients is 2.414 times higher than that of normal patients, higher than those of the ESPEN 2015 and SGA criteria (1.786 and 1.745 times, respectively). The random forest classifications show that the GLIM criteria have a higher ability to predict complications in these elderly patients than the SGA and ESPEN 2015 criteria with a mean decrease in accuracy of 12.929, 10.251, and 5.819, respectively, and a mean decrease in Gini of 2.055, 1.817, and 1.614, respectively. Conclusion: The prevalence of malnutrition diagnosed with the GLIM criteria is higher than that of the SGA and the ESPEN 2015 criteria. The GLIM criteria are better than the SGA and the ESPEN 2015 criteria for predicting in-hospital complications in elderly patients.

Current status of the association between malnutrition defined by the GLIM criteria and postoperative outcomes in gastrointestinal surgery for cancer: a narrative review.

In 2018, the Global Leadership Initiative on Malnutrition consortium published global consensus diagnostic criteria for malnutrition and highlighted the association between malnutrition and poor postoperative outcomes in patients with gastrointestinal cancer. The aforementioned criteria consist of phenotypic and etiologic criteria to diagnose malnutrition in individuals who undergo conventional screening to determine the at-risk population. Recent studies have reported the usefulness of prediction of postoperative outcomes using body mass index, weight loss, and reduced muscle mass as phenotypic criteria. Reduced muscle mass is an essential diagnostic criterion for sarcopenia, which is associated with poor outcomes in patients with cancer. The Global Leadership Initiative on Malnutrition criteria define reduced muscle mass as undernutrition. Malnutrition diagnosed based on the Global Leadership Initiative on Malnutrition criteria is an important risk factor for postoperative complications and also an independent poor prognostic factor for long-term outcomes; greater severity of malnutrition is associated with poorer outcomes. The current Global Leadership Initiative on Malnutrition criteria for malnutrition accurately predict outcomes, including postoperative complications and long-term prognosis; however, a revision may be warranted to ensure consistency with the diagnostic criteria for sarcopenia. Patients diagnosed with malnutrition based on the Global Leadership Initiative on Malnutrition criteria should be targeted for nutritional intervention. Further accumulation of evidence is necessary to conclusively establish the role of nutritional interventions in patients with malnutrition to improve postoperative complications and long-term outcomes.

Malnutrition is associated with postoperative complications in elderly patients undergoing total hip arthroplasty

IntroductionMalnutrition in elderly patients with hip fracture has been described as a factor associated with poor outcomes. This evidence for elderly patients undergoing elective total hip arthroplasty (THA) for osteoarthritis is not well-established. MethodsWe retrospectively studied a cohort of patients with an age ≥65 years admitted to the hospital for THA between January 2018 and December 2020. Demographic characteristics were collected. Albumin and total lymphocyte count were included in the pre-operative analysis and 24h postoperatively. Nutritional screening was carried out 24h postoperatively. GLIM criteria were applied for the diagnosis of malnutrition. Results25 patients out of the total cohort of 65 (38.4%) were malnourished. Five out of six patients (83.3%) with postoperative complications presented malnutrition compared with 20 of 59 patients (33.8%) without postoperative complications (P=0.028). Mean length of stay (LOS) was 3.49±0.88 days. Five out of six (83.3%) patients with postoperative complications presented LOS >3 days compared with one out of six patients (16.6%) with LOS ≤3 days (P=0.009).26 patients (40%) were referred to a community health centre, no differences in diagnosis of malnutrition were detected compared with patients who were discharged home.Patients with a diagnosis of malnutrition were significantly older, had a lower body mass index (BMI), a lower preoperative and postoperative albumin and worse anthropometric parameters. ConclusionsMalnutrition is associated with postoperative complications and longer LOS in elderly patients with elective THA. Risk factors for malnutrition are older age and low BMI.

Diagnosis of malnutrition according to glim criteria predicts complications and six-month survival in cancer outpatients.

e24093 Background: Malnutrition is a condition with great impact in oncology patients. Poor nutritional status is often associated with increased morbidity and mortality, increased toxicity and reduced tolerance to chemotherapy, among other complications. The recent GLIM criteria for malnutrition aim to homogenize its diagnosis, considering the baseline disease status. Due to the few studies that assess the predictive capacity of these new criteria, we aimed to evaluate their performance for the prediction of complications and mortality in patients with cancer. Methods: Prospective, single-centre study. All outpatients under active treatment for head and neck, upper gastrointestinal and colorectal tumors between February and October 2020 were recruited. These patients were followed up for 6 months, assessing the occurrence of complications and survival, based on GLIM diagnosis of malnutrition. Results: We enrolled 165 outpatients 46.66% malnutrition. During 6-month follow-up, patients with malnutrition (46.7%, according to GLIM criteria) had an ̃3-fold increased risk of hospital admission (p &lt; 0.001) and the occurrence of severe infections (considered as such those requiring hospitalization, intravenous antibiotics and/or drainage by interventional procedure) during follow-up (p = 0.002). Similarly, malnourished patients had a 3.5-fold increased risk of poor pain control and a 4.4-fold increased need for a higher dose of opioids (both p &lt; 0.001). They also had a 2.6-fold increased risk of toxicity (p = 0.044) and a 2.5-fold increased likelihood of needing a dose decrease or discontinuation of cancer treatment (p = 0.011). 6-month survival of malnourished patients was significantly lower (p = 0.023) than non-malnourished patients. Conclusions: Diagnosis of malnutrition according to GLIM criteria in oncology patients on active treatment predicts increased complications and worse survival at 6-month follow-up, making them a useful tool to assess the nutritional status of oncology patients.[Table: see text]

GLIM criteria and nutritional assesment in patients with heart failure

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Muscular Ultrasonography in Morphofunctional Assessment of Patients with Oncological Pathology at Risk of Malnutrition.

Background: Muscular ultrasonography is a technique that allows assessing the amount and quality of muscle in a specific body region. The aim of the study was to compare the value of muscle ultrasonography in diagnosis of malnutrition with techniques such as anthropometry, handgrip strength and impedanciometry in patients with oncological pathology. Methods: Cross-sectional study in 43 patients with oncological pathology and high nutritional risk. Classical anthropometry (body mass index (BMI), arm circumference (AC), calf circumference (CC) and estimated appendicular muscle mass index (ASMI)) was performed. Body composition was measured with impedanciometry (BIA), phase angle (PA) and fat-free mass index (FFMI) and muscle ultrasonography of quadriceps rectus femoris (muscle area (MARA) and circumference (MCR) in section transverse). Malnutrition was diagnosed using the GLIM criteria and sarcopenia was assessed using EWGSOP2 criteria. Results: The mean age was 68.26 years (±11.88 years). In total, 23/20 of the patients were men/women. The BMI was 23.51 (4.75) kg/m2. The ASMI was 6.40 (1.86) kg/m2. The MARA was 3.31 cm2 in ultrasonography. In impedanciometry, phase angle was 4.91 (0.75)°; the FFMI was 17.01 kg/m2 (±2.65 kg/m2). A positive correlation was observed between the MARA with anthropometric measurements (AC: r = 0.39, p = 0.009; CC: r = 0.44, p < 0.01; ASMI: r = 0.47, p < 0.001); and with BIA (FFMI: r = 0.48, p < 0.01 and PA: r = 0.45, p < 0.001). Differences were observed when comparing the MARA based on the diagnosis of sarcopenia (Sarcopenia: 2.47 cm2 (±0.54 cm2); no sarcopenia: 3.65 cm2 (±1.34 cm2); p = 0.02). Conclusions: Muscle ultrasonography correlates with body composition measurement techniques such as BIA and anthropometry in patients with cancer.

Optimal Assessment of Nutritional Status in Older Subjects with the Chronic Obstructive Pulmonary Disease-A Comparison of Three Screening Tools Used in the GLIM Diagnostic Algorithm.

Chronic obstructive pulmonary disease (COPD) is a recognized risk factor for malnutrition. The European Respiratory Society (ERS) statement included nutritional status assessment and dietary intervention as essential components of comprehensive management in subjects with COPD. According to the GLIM algorithm, the first step in diagnosing malnutrition is risk screening with a validated tool. Our study aimed to assess the diagnostic performance of three screening tools (MNA-SF, MUST, and NRS-2002) used in the GLIM algorithm in older patients with COPD. Additionally, we evaluated the agreement between these tools in the diagnostics of malnutrition. We performed a cross-sectional study of 124 patients aged at least 60 years with COPD diagnosed, based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD). We assessed the participants’ nutritional status with the three examined screening questionnaires (MNA-SF, MUST, and NRS-2002). Regardless of their results, we performed full malnutrition diagnostics following the GLIM algorithm in all subjects. The proportion of malnourished participants varied from 18.5% for the MUST questionnaire to 27.4% for the MNA-SF and 57.3% for the NRS-2002 score. Based on the GLIM criteria, malnutrition was diagnosed in 48 subjects (38.7%). All assessed questionnaires had an unsatisfactory sensitivity against the GLIM criteria for malnutrition: it was fair (58.3%) for the MNA-SF tool and poor for the MUST and NRS-2002 questionnaires (47.9% for both questionnaires). Considering the negative health consequences of malnutrition, a full diagnostic including GLIM etiologic and phenotypic criteria should be recommended in all elderly patients with COPD, regardless of the screening results.

Paving the way for applying GLIM criteria in clinical practice and research: how to define mild to moderate and severe reduced muscle mass.

Among approaches to adjust skeletal muscle mass (SMM) for body size, adjustment for body mass index (BMI) correlated better with functional measures. To enhance applicability of GLIM criteria, we report grade 1 and grade 2 reduced muscle mass cut-offs for SMM adjusted by BMI. 301 young, healthy adults involving students, patient relatives and staff working in the university hospital were included. SMM was estimated by bio-impedance analysis (BIA). SMM index (BMI) [SMMI(BMI)] was calculated as SMM/BMI. Grade 1 low muscle mass (LMM) was defined as "mean young SMMI(BMI)-one standard deviation" and grade 2 LMM as "mean young SMMI(BMI)-two standard deviations". Mean age was 26.5 ± 4.6 (62.1% male). Grade 1 vs grade 2 LMM thresholds were 1.189 and 0.954kg/BMI vs 1.049 and 0.823kg/BMI in males and females, respectively. This is the first report identifying stage 1 and stage 2 LMM thresholds for SMMI adjusted by BMI. Studies are needed to evaluate their predictive validity.

PREVALENCE OF MALNUTRITION, ACCORDING TO THE GLIM CRITERIA, IN PATIENTS WHO ARE THE CANDIDATES FOR GASTROINTESTINAL TRACT SURGERY.

ABSTRACT - BACKGROUND:Surgical patients constitute a group of individuals who are commonly underdiagnosed and undertreated, where nutritional impairment can be either a preexisting finding or a result of the hypercatabolic and hypermetabolic state.OBJECTIVE: The purpose of this study was to assess the prevalence of malnutrition, according to the GLIM criteria, and its association with clinical and nutritional factors, in individuals admitted to a surgical unit of a general hospital.METHODS: A cross-sectional, retrospective study was conducted, involving patients in the preoperative period due to gastrointestinal diseases. Demographic, clinical, and nutritional data were collected from adult and elderly patients admitted to a surgical unit between March and December 2019. Nutritional risk was assessed using the Nutritional Risk Screening tool (NRS-2002). The prevalence of malnutrition was found using the GLIM criteria. Binary logistic regression modeling was performed to determine the association between the diagnosis of malnutrition using the GLIM method and clinical and nutritional variables.RESULTS: The majority of the sample presented nutritional risk (50.2%) according to the NRS-2002. The prevalence of malnutrition according to the GLIM criteria was 32.3%, with severe malnutrition being predominant (21.2%) in all age groups. There was an association between malnutrition and nutritional risk detected by the NRS-2002 (OR: 5.791; 95%CI 3.201-10.478). There was a predominance of patients undergoing cancer surgery (64%) and these patients were more likely to be diagnosed with malnutrition (OR: 2.068; 95%CI: 1.161-3.683), after statistical adjustment.CONCLUSION: An important prevalence of nutritional risk assessed by the NRS-2002 and of malnutrition assessed by the GLIM method was identified, especially in its severe form. In addition, preoperative patients with nutritional risk, as detected using the NRS-2002 nutritional screening tool, and candidates for oncologic surgery are more likely to be diagnosed as malnourished using the GLIM criteria.

Texture-Modified Diets Need to be Improved in Vietnamese Hospitals.

Purpose : The aim of this study is to compare the nutritional status of older adult inpatients consuming Texture-Modified Diets (TMD) to older adult inpatients consuming a regular diet. Methods : The study was designed as cross-sectional and was conducted in three large hospitals in northern Vietnam. The data for 344 older adult inpatients were collected in 2021 by dietitians. Results : The result showed 104 subjects were prescribed TMD. The textures of hospital diets have still not been adequately developed. In particular, the hospitals had not yet developed pureed meals. All older adult inpatients (74.7 ± 6.8 years old, 52.9% female) had 28.8% malnutrition by the GLIM criteria. The TMD group had a malnutrition prevalence two times higher than the regular diet group. Total energy intake from hospital meal and outside snacks in the regular diet group was higher than in the TMD group, about 150 kcal. Although energy provided from the hospital diet in both groups was similar, hospital meal wastage in the TMD group was higher than in the regular diet group. Conclusion : The older adult inpatients on TMD may have a nutritional status worse than those consuming a regular diet. Hospital diets need to be improved in texture and quality. J. Med. Invest. 69 : 230-236, August, 2022.

Malnutrition dynamics according to GLIM criteria in hospitalized elderly.

Assess the different nutritional status between admission and discharged in older adult patients using the GLIM criteria. A retrospective analysis was conducted on a multicenter study which initiated in 34 hospitals in China with 2734 hospitalized older patients. The dynamic changes of malnutrition according to GLIM criteria were performed between at admission and discharge, and their significance was analyzed using the chi-square test. The association between malnutrition and clinical outcomes was analyzed using the chi-square test, t-test, or rank sum test, and divided into different disease types for further analysis. The incidence of nutritional risk in elderly patients was 51.6% at admission and 48.4% at discharge. The prevalence of malnutrition according to the GLIM criteria was 19.6% at admission and increased to 33.4% at discharge, which was significantly different. Different age and disease type were related with nutrition status. Malnutrition is significantly association with adverse clinical outcomes such as increased risk of complications and prolonged length of hospital stay. The GLIM criteria can be used in elderly patients to assess malnutrition. The prevalence of malnutrition in elderly inpatients is high, and the prevalence of malnutrition at discharge is higher than that observed at admission. Attention should be paid to the dynamic changes of malnutrition in elderly patients during hospitalization.

Association between glim criteria and presence of pressure injury in hospitalized patients

Rationale: Recent studies show that hospitalized malnourished patients are at an increased risk of developing pressure injuries. The GLIM nutritional diagnosis tool proposed in 2019 uses etiological and phenotypic criteria to diagnose malnutrition. The aim of this study is to correlate nutritional status, using the GLIM criteria, with the presence and the stage of pressure injury in patients admitted to a large philanthropic hospital in São Paulo, Brazil.

Gut microbiota diversity in glim-defined malnourished acutely ill older adults

Rationale: Malnutrition is a common clinical condition in hospitalised older adults. The gut microbiota has suggested a bidirectional regulatory feature in health and diseases. We explored the gut microbiota diversity in malnourished (MN) and well-malnourished (WN) older patients classified by the GLIM criteria.

Assessment of malnutrition in older patients with acute stroke by different nutritional screening tools and glim criteria

Rationale: We aimed to investigate the malnutrition rate in older patients with acute stroke by using different nutritional screening tools and the Global Leadership Initiative on Malnutrition (GLIM) criteria, and compare the agreement rates between them.

Nutrition diagnosis and length of hospital stay based on glim criteria

Rationale: At our hospital, we have started nutritional diagnosis based on the GLIM Craiteria (The Global Leadership Initiative on Malnutrition) for scheduled inpatients. We report on the prevalence of sarcopenia and length of hospital stay in patients diagnosed with malnutrition by GLIM.