Validation of GLIM criteria on malnutrition in older Chinese inpatients

ObjectiveMalnutrition is a nutritional disorder and common syndrome that has a high incidence and is easily ignored in hospitalized older patients. It can lead to multiple poor prognoses, such as frailty. Early identification and correct evaluation of possible malnutrition and frailty are essential...

Full description

Bibliographic Details
Main Authors: Tong Ji, Yun Li, Pan Liu, Yaxin Zhang, Yu Song, Lina Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Nutrition
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2022.969666/full
_version_ 1798000971102552064
author Tong Ji
Yun Li
Pan Liu
Yaxin Zhang
Yu Song
Lina Ma
author_facet Tong Ji
Yun Li
Pan Liu
Yaxin Zhang
Yu Song
Lina Ma
author_sort Tong Ji
collection DOAJ
description ObjectiveMalnutrition is a nutritional disorder and common syndrome that has a high incidence and is easily ignored in hospitalized older patients. It can lead to multiple poor prognoses, such as frailty. Early identification and correct evaluation of possible malnutrition and frailty are essential to improve clinical outcomes in older patients. Therefore, our objective was to explore the applicability and effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria for identifying malnutrition in older patients.MethodsIn total, 223 participants aged ≥60 years were involved. Nutrition was evaluated using the Mini Nutritional Assessment-Full Form (MNA-FF) and GLIM criteria, which adopt a two-step procedure. The first step was to use three different methods for the screening of nutritional risk: the Nutrition Risk Screening 2002, the Mini Nutritional Assessment Short Form (MNA-SF), and the Malnutrition Universal Screening Tool. The second step was to link a combination of at least one phenotypical criterion and one etiological criterion to diagnose malnutrition. The Clinical Frailty Scale was used to assess frailty. Sensitivity, specificity, Youden index, kappa values, and positive and negative predictive values were used to evaluate the validity of the GLIM criteria. Logistic regression models were used to assess whether there was a correlation between malnutrition, as defined by the GLIM criteria, and frailty.ResultsWe found that 32.3–49.8% of our patient sample were at risk of malnutrition based on the GLIM diagnosis and using the three different screening tools; 19.3–27.8% of the patients were malnourished. GLIM criteria with MNA-SF as a diagnostic validation and MNA-FF as a reference showed high consistency (K = 0.629; p < 0.001), sensitivity (90.5%), and specificity (86.4%). Logistic regression analysis showed that malnutrition, using MNA-SF with the GLIM criteria, was relevant for a higher likelihood of frailty (OR = 1.887; 95% CI 1.184–2.589).ConclusionsThe incidence of GLIM-defined malnutrition was 19.3–27.8% using different screening tools. The consistency between the GLIM criteria using the MNA-SF and the MNA methods was high. Malnutrition, as diagnosed by the GLIM criteria with MNA-SF, was significantly correlated with frailty. GLIM criteria with MNA-SF may be a more reliable malnutrition assessment process in older inpatients.
first_indexed 2024-04-11T11:28:40Z
format Article
id doaj.art-e671acb3a58d46438e15285288b952c7
institution Directory Open Access Journal
issn 2296-861X
language English
last_indexed 2024-04-11T11:28:40Z
publishDate 2022-09-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Nutrition
spelling doaj.art-e671acb3a58d46438e15285288b952c72022-12-22T04:26:12ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-09-01910.3389/fnut.2022.969666969666Validation of GLIM criteria on malnutrition in older Chinese inpatientsTong JiYun LiPan LiuYaxin ZhangYu SongLina MaObjectiveMalnutrition is a nutritional disorder and common syndrome that has a high incidence and is easily ignored in hospitalized older patients. It can lead to multiple poor prognoses, such as frailty. Early identification and correct evaluation of possible malnutrition and frailty are essential to improve clinical outcomes in older patients. Therefore, our objective was to explore the applicability and effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria for identifying malnutrition in older patients.MethodsIn total, 223 participants aged ≥60 years were involved. Nutrition was evaluated using the Mini Nutritional Assessment-Full Form (MNA-FF) and GLIM criteria, which adopt a two-step procedure. The first step was to use three different methods for the screening of nutritional risk: the Nutrition Risk Screening 2002, the Mini Nutritional Assessment Short Form (MNA-SF), and the Malnutrition Universal Screening Tool. The second step was to link a combination of at least one phenotypical criterion and one etiological criterion to diagnose malnutrition. The Clinical Frailty Scale was used to assess frailty. Sensitivity, specificity, Youden index, kappa values, and positive and negative predictive values were used to evaluate the validity of the GLIM criteria. Logistic regression models were used to assess whether there was a correlation between malnutrition, as defined by the GLIM criteria, and frailty.ResultsWe found that 32.3–49.8% of our patient sample were at risk of malnutrition based on the GLIM diagnosis and using the three different screening tools; 19.3–27.8% of the patients were malnourished. GLIM criteria with MNA-SF as a diagnostic validation and MNA-FF as a reference showed high consistency (K = 0.629; p < 0.001), sensitivity (90.5%), and specificity (86.4%). Logistic regression analysis showed that malnutrition, using MNA-SF with the GLIM criteria, was relevant for a higher likelihood of frailty (OR = 1.887; 95% CI 1.184–2.589).ConclusionsThe incidence of GLIM-defined malnutrition was 19.3–27.8% using different screening tools. The consistency between the GLIM criteria using the MNA-SF and the MNA methods was high. Malnutrition, as diagnosed by the GLIM criteria with MNA-SF, was significantly correlated with frailty. GLIM criteria with MNA-SF may be a more reliable malnutrition assessment process in older inpatients.https://www.frontiersin.org/articles/10.3389/fnut.2022.969666/fullmalnutritionfrailtyGLIM criterianutritional screening toolshospitalized older patients
spellingShingle Tong Ji
Yun Li
Pan Liu
Yaxin Zhang
Yu Song
Lina Ma
Validation of GLIM criteria on malnutrition in older Chinese inpatients
Frontiers in Nutrition
malnutrition
frailty
GLIM criteria
nutritional screening tools
hospitalized older patients
title Validation of GLIM criteria on malnutrition in older Chinese inpatients
title_full Validation of GLIM criteria on malnutrition in older Chinese inpatients
title_fullStr Validation of GLIM criteria on malnutrition in older Chinese inpatients
title_full_unstemmed Validation of GLIM criteria on malnutrition in older Chinese inpatients
title_short Validation of GLIM criteria on malnutrition in older Chinese inpatients
title_sort validation of glim criteria on malnutrition in older chinese inpatients
topic malnutrition
frailty
GLIM criteria
nutritional screening tools
hospitalized older patients
url https://www.frontiersin.org/articles/10.3389/fnut.2022.969666/full
work_keys_str_mv AT tongji validationofglimcriteriaonmalnutritioninolderchineseinpatients
AT yunli validationofglimcriteriaonmalnutritioninolderchineseinpatients
AT panliu validationofglimcriteriaonmalnutritioninolderchineseinpatients
AT yaxinzhang validationofglimcriteriaonmalnutritioninolderchineseinpatients
AT yusong validationofglimcriteriaonmalnutritioninolderchineseinpatients
AT linama validationofglimcriteriaonmalnutritioninolderchineseinpatients