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

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.sss