Liu Chengyu, Lu Zhenhua, Li Zijian, Xu Jingyong, Cui Hongyuan, Zhu Mingwei
Department of General Surgery, National Center of Gerontology, Beijing Hospital, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
The Key Laboratory of Geriatrics, National Center of Gerontology, National Health Commission, Beijing Hospital, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Front Nutr. 2021 Dec 24;8:774636. doi: 10.3389/fnut.2021.774636. eCollection 2021.
Malnutrition is prevalent among patients with cancer. The Global Leadership Initiative on Malnutrition (GLIM) released new universal criteria for diagnosing malnutrition in 2019. The objectives of this study were to assess the prevalence of malnutrition in patients with cancer using the GLIM criteria, explore the correlation between the GLIM criteria, and clinical outcomes, and compare the GLIM criteria with subjective global assessment (SGA). This retrospective analysis was conducted on 2,388 patients with cancer enrolled in a multicenter study. Nutritional risk was screened using the Nutritional Risk Screening-2002, and the nutritional status was assessed using SGA and GLIM criteria. Chi-square analysis and Wilcoxon rank sum test, stratified by age 65 years, were used to evaluate the effect of GLIM-defined malnutrition on clinical outcomes. Logistic regression analysis was used to analyze the nutritional status and complications, and the interrater reliability was measured using a kappa test. The prevalence of malnutrition defined by the GLIM criteria was 38.9% (929/2,388). GLIM-defined malnutrition was significantly associated with in-hospital mortality ( = 0.001) and length of hospital stays ( = 0.001). Multivariate logistic regression analysis showed GLIM-defined malnutrition significantly increased complications (odds ratio [] 1.716, 95% 1.227-2.400, = 0.002). The GLIM criteria had a "moderate agreement" (kappa = 0.426) compared with the SGA. The prevalence of malnutrition in hospitalized patients with cancer is high, and malnourishment in patients with cancer is associated with poorer clinical outcomes. The use of the GLIM criteria in assessing the nutritional status of inpatients with cancer is recommended and can be used as the basis for nutritional interventions.
营养不良在癌症患者中普遍存在。全球营养不良领导倡议组织(GLIM)于2019年发布了诊断营养不良的新通用标准。本研究的目的是使用GLIM标准评估癌症患者中营养不良的患病率,探讨GLIM标准与临床结局之间的相关性,并将GLIM标准与主观全面评定法(SGA)进行比较。 这项回顾性分析针对纳入一项多中心研究的2388例癌症患者进行。使用营养风险筛查-2002筛查营养风险,并使用SGA和GLIM标准评估营养状况。采用按65岁分层的卡方分析和Wilcoxon秩和检验来评估GLIM定义的营养不良对临床结局的影响。采用逻辑回归分析营养状况与并发症之间的关系,并使用kappa检验测量评分者间信度。 GLIM标准定义的营养不良患病率为38.9%(929/2388)。GLIM定义的营养不良与住院死亡率( = 0.001)和住院时间( = 0.001)显著相关。多因素逻辑回归分析显示,GLIM定义的营养不良显著增加并发症(比值比[]1.716,95% 1.227 - 2.400, = 0.002)。与SGA相比,GLIM标准具有“中度一致性”(kappa = 0.426)。 住院癌症患者中营养不良的患病率很高,癌症患者的营养不良与较差的临床结局相关。建议使用GLIM标准评估癌症住院患者的营养状况,并可作为营养干预的依据。