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Association between GLIM criteria for diagnosis of malnutrition and hospital mortality in patients receiving parenteral nutrition

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Abstract

Purpose

The Global Leadership Initiative on Malnutrition (GLIM) is a new nutritional assessment tool but must be validated in different scenarios. Thus, our objective was to evaluate the association between the GLIM criteria with hospital mortality in patients receiving parenteral nutrition (PN).

Methods

This was a retrospective clinical study, with clinical and surgical patients receiving PN during hospitalization. Nutritional status was assessed by the GLIM criteria and demographics, laboratorial, anthropometric, and nutritional data were collected. The GLIM criteria include a phenotypic criteria (low BMI < 20 kg/m2 if < 70 years or < 22 kg/m2 if > 70 years) and etiologic criteria (CRP > 1.0 mg/dL). All patients were followed up during the PN period and the hospital mortality was the primary outcome. The logistic regression model was performed to assess hospital mortality.

Results

Among the 90 patients evaluated, 46.6% died during hospital stay and 21.1% had malnutrition. The age was 63 (46–74) years, 61.1% were men, and regarding the underlying diseases, 74.4% of the patients had gastrointestinal disorders, 3.3% polytrauma, and 22.38% other diseases. CRP mean was 31.3 ± 19.3 mg/dL and the median of BMI was 24.8 (21.6–28.5) kg/m2. In a logistic regression model adjusted by sex and age, the serum albumin concentration was associated with hospital mortality rate (OR: 0.321; 95% CI: 0.142–0.727; p: 0.006). Despite this adjustment, the diagnosis of malnutrition was not associated with hospital mortality (OR: 1.498; 95% CI: 0.496–4.521; p: 0.473).

Conclusion

GLIM-defined malnutrition is not associated with hospital mortality in patients receiving PN. Also, the evaluation of inflammatory markers seems to be more important than only as etiologic criteria

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Abbreviations

GLIM:

Global Leadership Initiative on Malnutrition

PN:

Parenteral nutrition

BMI:

Body mass index

CRP:

C-reactive protein

NUTRIC:

Nutrition Risk in the Critically ill Score

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Authors and Affiliations

  1. Department of Internal Medicine, Botucatu Medical School, São Paulo State University - UNESP, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, UNESP - Campus de Botucatu, Botucatu, 18618687, Brazil

    Amanda Gomes Pereira, Daniela Salate Biagioni Vulcano, Mariana Bordinhon de Moraes, Mariana de Souza Dorna, Bertha Furlan Polegato, Leonardo Antonio Mamede Zornoff, Paula Schmidt Azevedo, Marcos Ferreira Minicucci & Sergio Alberto Rupp Paiva

  2. Faculty of Nutrition, Federal University of Goiás - UFG, Goiânia, Brazil

    Nara Aline Costa

Authors
  1. Amanda Gomes Pereira
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  2. Nara Aline Costa
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  3. Daniela Salate Biagioni Vulcano
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Contributions

A.G.P., N.A.C., and S.A.R.P. equally contributed to the conception and design of the research; D.S.B.V., M.B.M., and M.S.D. contributed to the acquisition and analysis of the data; B.F.P., L.A.M.Z., P.S.A., and S.A.R.P. contributed to the interpretation of the data; N.A.C., A.G.P., M.F.M., and S.A.R.P. drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding author

Correspondence to Amanda Gomes Pereira.

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Pereira, A.G., Costa, N.A., Vulcano, D.S.B. et al. Association between GLIM criteria for diagnosis of malnutrition and hospital mortality in patients receiving parenteral nutrition. Nutrire 46, 9 (2021). https://doi.org/10.1186/s41110-021-00138-4

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