Applicability of Global Leadership Initiative on Malnutrition (GLIM) criteria in nutrition risk screening for patients over 60 years old with digestive system tumors – A retrospective study

IF 0.5 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Nutrition Clinique et Metabolisme Pub Date : 2024-08-10 DOI:10.1016/j.nupar.2024.06.002
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Abstract

Objective

This study aimed to identify the most effective nutritional risk screening tool for elderly patients with digestive system tumors.

Methods

Nutritional risk screening was performed using Nutritional Risk Screening 2002 (NRS2002), prognostic nutritional index (PNI) and Geriatric Nutritional Risk Index (GNRI) for elderly patients who underwent surgical resection of digestive tumor. Comparative analysis of each nutritional screening tool was conducted through Kappa test and ROC curve.

Results

Malnourished individuals diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria had lower levels of hematological parameters (serum albumin, pre-albumin, total protein and hemoglobin) and poorer body composition parameters (body mass index, body fat percentage, edema index, upper arm muscle circumference, skeletal muscle index, and phase angle; P < 0.05). NRS2002 demonstrated a sensitivity of 75.56% and specificity of 38.16% under the GLIM criteria, showing moderate agreement (Kappa = 0.346, P < 0.001). PNI had an average sensitivity of 71.11% and the highest specificity at 87.23%, but exhibited no consistency with GLIM (Kappa = 0.152, P = 0.062). GNRI showed the highest sensitivity at 91.11% and general specificity at 37.14%, aligning closely with GLIM criteria (Kappa = 0.711, P < 0.001). GNRI had the highest predictive value (AUC = 0.870, 95% CI: 0.801–0.939), followed by NRS2002 (AUC = 0.687, 95% CI: 0.589–0.785). Patients diagnosed with malnutrition via GNRI-GLIM exhibited higher rates of surgical site infection (χ2 = 15.534, P < 0.001) and 3-month readmission (χ2 = 4.499, P = 0.034).

Conclusion

GNRI and NRS2002 demonstrate good performance as GLIM criteria for nutritional screening in elderly patients with digestive tumors, with GNRI being potentially more suitable. Moreover, GNRI-GLIM can predict short-term prognosis in these patients.

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全球营养不良领导倡议(GLIM)标准在 60 岁以上消化系统肿瘤患者营养风险筛查中的适用性 - 一项回顾性研究
方法采用营养风险筛查2002(NRS2002)、预后营养指数(PNI)和老年营养风险指数(GNRI)对接受消化系统肿瘤手术切除的老年患者进行营养风险筛查。结果根据全球领导力营养不良倡议(GLIM)标准诊断出的营养不良者血液学参数(血清白蛋白、前白蛋白、总蛋白和血红蛋白)水平较低,身体成分参数(体重指数、体脂百分比、水肿指数、上臂肌围、骨骼肌指数和相位角;P <0.05)较差。根据 GLIM 标准,NRS2002 的灵敏度为 75.56%,特异性为 38.16%,显示出中等程度的一致性(Kappa = 0.346,P <0.001)。PNI 的平均灵敏度为 71.11%,特异性最高,为 87.23%,但与 GLIM 没有一致性(Kappa = 0.152,P = 0.062)。GNRI 的灵敏度最高,为 91.11%,特异性最高,为 37.14%,与 GLIM 标准非常一致(Kappa = 0.711,P <0.001)。GNRI 的预测值最高(AUC = 0.870,95% CI:0.801-0.939),其次是 NRS2002(AUC = 0.687,95% CI:0.589-0.785)。结论GNRI 和 NRS2002 作为消化系统肿瘤老年患者营养筛查的 GLIM 标准表现良好,其中 GNRI 可能更适合。此外,GNRI-GLIM 还能预测这些患者的短期预后。
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来源期刊
Nutrition Clinique et Metabolisme
Nutrition Clinique et Metabolisme 医学-内分泌学与代谢
CiteScore
0.80
自引率
16.70%
发文量
216
审稿时长
78 days
期刊介绍: Nutrition Clinique et Métabolisme is the journal of the French-speaking Society of Enteral and Parenteral Nutrition. Associating clinicians, biologists, pharmacists, and fundamentalists, the articles presented in the journal concern man and animals, and deal with organs and cells. The goal is a better understanding of the effects of artificial nutrition and human metabolism. Original articles, general reviews, update articles, technical notes and communications are published, as well as editorials and case reports.
期刊最新文献
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