Global Leadership Initiative on Malnutrition criteria using calf and upper arm circumference as phenotypic criteria for assessing muscle mass demonstrate satisfactory validity for diagnosing malnutrition in hospitalized patients: A prospective cohort study.

IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Nutrition in Clinical Practice Pub Date : 2024-12-01 Epub Date: 2024-08-07 DOI:10.1002/ncp.11200
Larissa Farinha Maffini, Gabrielle Maganha Viegas, Thais Steemburgo, Gabriela Corrêa Souza
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Abstract

Background: Hospitalized individuals present high rates of malnutrition and loss of muscle mass (MM). Imaging techniques for assessing MM are expensive and scarcely available in hospital practice. The Global Leadership Initiative on Malnutrition (GLIM) proposed a framework for malnutrition diagnosis that includes simple measurements to assess MM, such as calf circumference (CC) and mid-upper arm circumference (MUAC). This study aimed to analyze the validity of the GLIM criteria with CC and MUAC for malnutrition diagnosis, using Subjective Global Assessment (SGA) as the reference standard, in inpatients.

Methods: A prospective cohort study was conducted on 453 inpatient adults in a university hospital. The presence of malnutrition was assessed within 48 h of hospital admission using SGA and GLIM criteria using CC and MUAC as phenotypic criteria for malnutrition diagnosis. Accuracy, agreement tests, and logistic regression analysis adjusted for confounders were performed to test the validity of the GLIM criteria for malnutrition diagnosis.

Results: The patients were aged 59 (46-68) years, 51.4% were male, and 67.8% had elective surgery. Compared with SGA, the GLIM criteria using the two MM assessment measures showed good accuracy (area under the curve > 0.80) and substantial agreement (κ > 0.60) for diagnosing malnutrition. The highest sensitivity was obtained with GLIMCC (89%), whereas GLIMMUAC showed high specificity (>90%). Also, malnutrition identified by GLIMCC and GLIMMUAC was significantly associated with prolonged hospitalization and in-hospital death.

Conclusion: In the absence of imaging techniques to assess MM, the use of CC and MUAC measurements from the GLIM criteria demonstrated satisfactory validity for diagnosing malnutrition in hospitalized patients.

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全球营养不良领导力倡议 "的标准使用小腿和上臂围度作为评估肌肉质量的表型标准,在诊断住院患者营养不良方面显示出令人满意的有效性:一项前瞻性队列研究。
背景:住院病人营养不良和肌肉质量下降(MM)的发生率很高。用于评估肌肉质量的成像技术价格昂贵,在医院实践中很少使用。全球营养不良领导倡议(GLIM)提出了一个营养不良诊断框架,其中包括评估肌肉质量的简单测量方法,如小腿围(CC)和中上臂围(MUAC)。本研究旨在以主观全面评估(SGA)为参考标准,分析 GLIM 标准与 CC 和 MUAC 在住院患者营养不良诊断中的有效性:方法:对一家大学医院的 453 名住院成人进行了前瞻性队列研究。采用 SGA 和 GLIM 标准,以 CC 和 MUAC 作为营养不良诊断的表型标准,评估入院 48 小时内是否存在营养不良。为检验 GLIM 营养不良诊断标准的有效性,对其进行了准确性、一致性测试和逻辑回归分析,并对混杂因素进行了调整:患者年龄为 59(46-68)岁,51.4% 为男性,67.8% 接受过择期手术。与 SGA 相比,使用两种 MM 评估方法的 GLIM 标准在诊断营养不良方面表现出良好的准确性(曲线下面积 > 0.80)和高度一致性(κ > 0.60)。GLIMCC 的灵敏度最高(89%),而 GLIMMUAC 的特异性较高(>90%)。此外,GLIMCC 和 GLIMMUAC 发现的营养不良与住院时间延长和院内死亡有显著关联:结论:在没有影像技术评估营养不良的情况下,使用GLIM标准中的CC和MUAC测量值诊断住院患者营养不良的有效性令人满意。
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来源期刊
CiteScore
6.00
自引率
9.70%
发文量
128
审稿时长
3 months
期刊介绍: NCP is a peer-reviewed, interdisciplinary publication that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. This journal is a member of the Committee on Publication Ethics (COPE).
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