Centre for Nutrition and Mohn Nutrition Research Laboratory, Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Department of Research and Development, Haukeland University Hospital, Bergen, Norway.
JPEN J Parenter Enteral Nutr. 2024 Apr;48(3):308-317. doi: 10.1002/jpen.2619. Epub 2024 Mar 13.
Risk of malnutrition and malnutrition have been previously associated with increased risk of mortality. It remains unclear, however, whether the severity of malnutrition differentiates in association with all-cause mortality. The aim was to assess the association between being at risk of malnutrition or being diagnosed with malnutrition according to the diagnostic assessment of the Global Leadership Initiative on Malnutrition (GLIM) with all-cause mortality during a 2-year follow-up in hospitalized patients.
A matched cohort study was conducted in hospitalized patients (excluding cancer, intensive care, and transmissible infections) at a university hospital in Bergen, Norway. All patients underwent nutrition screening with the Nutritional Risk Screening 2002 and a further nutrition assessment using the GLIM criteria. All-cause mortality was estimated from the Norwegian death registry after 2 years, and risk factors were calculated by Cox regression analysis.
Among 326 patients included, 55 patients died within 2 years (17% mortality rate). Risk of malnutrition was associated with increased all-cause mortality, which disappeared after adjustment for age and sex. Malnutrition was associated with an increased risk of all-cause mortality at 2 years also after adjustment for age and sex and, additionally, for further comorbidities (hazard ratio = 2.50; 95% CI, 1.41-4.42). When analyzed separately only severe malnutrition was associated with mortality (hazard ratio = 2.73; 95% CI, 1.44-5.15).
The findings highlight a strong association between inpatients with severe malnutrition, defined by the GLIM criteria, and an increased risk of all-cause mortality within a 2-year follow-up.
营养不良和营养风险与死亡率增加有关。然而，营养不良的严重程度是否与全因死亡率相关，目前尚不清楚。本研究旨在评估根据全球营养不良领导倡议（GLIM）的诊断评估，处于营养不良风险或被诊断为营养不良的住院患者在 2 年随访期间与全因死亡率之间的关系。
这是在挪威卑尔根一所大学医院进行的一项匹配队列研究，纳入了除癌症、重症监护和传染性感染外的住院患者。所有患者均接受营养风险筛查 2002（Nutritional Risk Screening 2002）和 GLIM 标准的进一步营养评估。2 年后，根据挪威死亡登记处估计全因死亡率，并通过 Cox 回归分析计算危险因素。
在纳入的 326 例患者中，55 例患者在 2 年内死亡（死亡率为 17%）。营养风险与全因死亡率增加相关，调整年龄和性别后这种相关性消失。在调整年龄、性别和其他合并症后，营养不良与 2 年内全因死亡率增加相关（危险比=2.50；95%置信区间，1.41-4.42）。仅当单独分析严重营养不良时，才与死亡率相关（危险比=2.73；95%置信区间，1.44-5.15）。
研究结果突出表明，根据 GLIM 标准定义的严重营养不良的住院患者与 2 年内全因死亡率增加之间存在很强的关联。
