Asako Mitani1,2, Takahito Iwai3,4, Toshiaki Shichinohe1,5, Hiroshi Takeda1,6, Satomi Kumagai1,7, Mutsumi Nishida2, Junichi Sugita2,8, Takanori Teshima2,8. 1. Nutrition Support Team, Hokkaido University Hospital, Sapporo, Japan. 2. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan. 3. Nutrition Support Team, Hokkaido University Hospital, Sapporo, Japan, takahito181@gmail.com. 4. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan, takahito181@gmail.com. 5. Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan. 6. Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan. 7. Department of Nutrition, Hokkaido University Hospital, Sapporo, Japan. 8. Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
Abstract
INTRODUCTION: The Global Leadership Initiative on Malnutrition (GLIM) lacks reliable blood tests for evaluating the nutrition status. We retrospectively compared the GLIM criteria, Controlling Nutrition Status (CONUT) score, and Subjective Global Assessment (SGA) to establish effective malnutrition screening and provide appropriate nutritional interventions according to severity. METHODS: We classified 177 patients into 3 malnutrition categories (normal/mild, moderate, and severe) according to the GLIM criteria, CONUT score, and SGA. We investigated the malnutrition prevalence, concordance of malnutrition severity, predictability of clinical outcome, concordance by etiology, and clinical outcome by inflammation. RESULTS: The highest prevalence of malnutrition was found using the GLIM criteria (87.6%). Concordance of malnutrition severity was low between the GLIM criteria and CONUT score. Concordance by etiology was low in all groups but was the highest in the "acute disease" group. The area under the curve of clinical outcome and that of the "with inflammation group" were significantly higher when using the CONUT score versus using the other tools (0.679 and 0.683, respectively). CONCLUSION: The GLIM criteria have high sensitivity, while the CONUT score can effectively predict the clinical outcome of malnutrition. Their combined use can efficiently screen for malnutrition and patient severity in acute care hospitals.
INTRODUCTION: The Global Leadership Initiative on Malnutrition (GLIM) lacks reliable blood tests for evaluating the nutrition status. We retrospectively compared the GLIM criteria, Controlling Nutrition Status (CONUT) score, and Subjective Global Assessment (SGA) to establish effective malnutrition screening and provide appropriate nutritional interventions according to severity. METHODS: We classified 177 patients into 3 malnutrition categories (normal/mild, moderate, and severe) according to the GLIM criteria, CONUT score, and SGA. We investigated the malnutrition prevalence, concordance of malnutrition severity, predictability of clinical outcome, concordance by etiology, and clinical outcome by inflammation. RESULTS: The highest prevalence of malnutrition was found using the GLIM criteria (87.6%). Concordance of malnutrition severity was low between the GLIM criteria and CONUT score. Concordance by etiology was low in all groups but was the highest in the "acute disease" group. The area under the curve of clinical outcome and that of the "with inflammation group" were significantly higher when using the CONUT score versus using the other tools (0.679 and 0.683, respectively). CONCLUSION: The GLIM criteria have high sensitivity, while the CONUT score can effectively predict the clinical outcome of malnutrition. Their combined use can efficiently screen for malnutrition and patient severity in acute care hospitals.
Keywords:
Clinical outcome; Controlling Nutrition Status score; Global Leadership Initiative on Malnutrition criteria; Malnutrition; Subjective Global Assessment
Authors: T Cederholm; R Barazzoni; P Austin; P Ballmer; G Biolo; S C Bischoff; C Compher; I Correia; T Higashiguchi; M Holst; G L Jensen; A Malone; M Muscaritoli; I Nyulasi; M Pirlich; E Rothenberg; K Schindler; S M Schneider; M A E de van der Schueren; C Sieber; L Valentini; J C Yu; A Van Gossum; P Singer Journal: Clin Nutr Date: 2016-09-14 Impact factor: 7.324
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