Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Division of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Nutr Clin Pract. 2023 Aug;38(4):798-806. doi: 10.1002/ncp.10969. Epub 2023 Feb 27.
Clinical care of patients with cancer mostly focuses on medical management with less attention on disease-related malnutrition. The Global Leadership Initiative on Malnutrition (GLIM) released new criteria for diagnosing malnutrition, but the validation of these criteria in treatment-naïve patients with cancer is not well documented. This study aimed to investigate the application of the GLIM criteria in nutrition assessment and mortality prediction in treatment-naïve patients with cancer.
A total of 267 patients newly diagnosed with different types of cancer were enrolled. Nutrition status was assessed with the Patient-Generated Subjective Global Assessment (PG-SGA) at outpatient clinic admission during the data collection period. Furthermore, after the GLIM criteria publication, nutrition status was assessed retrospectively using the GLIM criteria in the same cohort to assess validity. The agreement between the tools was calculated using kappa statistics, and the association of malnutrition according to each tool and mortality was analyzed using logistic regression analysis.
The mean age of the patients was 58.06 ± 12.6 years, and 42.7% were women. The prevalence of malnutrition was 60.3% with GLIM criteria and 53.6% with PG-SGA. Agreement between tools was moderate (κ = 0.483, P < 0.001). During a median follow-up period of 23.6 months, 99 deaths occurred. Both GLIM-defined and PG-SGA-defined malnutrition was independently associated with 2-year mortality after adjusting for age, sex, presence of comorbidities, and stage of cancer.
Our findings support the validation of GLIM in diagnosing malnutrition and predicting 2-year mortality among treatment-naïve patients with cancer.
癌症患者的临床护理主要侧重于医疗管理，而对疾病相关营养不良的关注较少。全球营养不良领导倡议（GLIM）发布了新的营养不良诊断标准，但这些标准在未经治疗的癌症患者中的验证情况记录不详。本研究旨在探讨 GLIM 标准在未经治疗的癌症患者营养评估和死亡率预测中的应用。
共纳入 267 例新诊断为不同类型癌症的患者。在数据收集期间，在门诊就诊时使用患者生成的主观整体评估（PG-SGA）评估营养状况。此外，在 GLIM 标准发布后，使用相同队列中的 GLIM 标准回顾性评估营养状况，以评估其有效性。使用 Kappa 统计计算工具之间的一致性，并使用逻辑回归分析评估根据每种工具确定的营养不良与死亡率之间的关联。
患者的平均年龄为 58.06±12.6 岁，42.7%为女性。GLIM 标准下的营养不良发生率为 60.3%，PG-SGA 标准下的营养不良发生率为 53.6%。两种工具之间的一致性为中度（κ=0.483，P<0.001）。在中位随访 23.6 个月期间，有 99 例死亡。在调整年龄、性别、合并症存在和癌症分期后，GLIM 定义和 PG-SGA 定义的营养不良均与 2 年死亡率独立相关。
我们的研究结果支持 GLIM 标准在诊断未经治疗的癌症患者的营养不良和预测 2 年死亡率方面的验证。
