Zhou Bei, Zhang Yupeng, Gao Xuejin, Liu Sitong, Shen Ruting, Huang Yingchun, Zhao Yang, Zhang Li, Wang Xinying
School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Department of General Surgery, Jinling Hospital, Nanjing, China.
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Asia Pac J Clin Nutr. 2025 Aug;34(4):665-676. doi: 10.6133/apjcn.202508_34(4).0017.
This study aimed to investigate nutritional status of hospitalized Chinese pa-tients according to the Global Leadership Initiative on Malnutrition (GLIM) and the European Society of Clin-ical Nutrition and Metabolism (ESPEN) criteria and to identify the effects of nutritional characteristics and nutritional support on clinical good outcome.
Inpatients participated in Chinese nutritionDay 2010-2020 surveys were included. Malnutrition was defined according to the ESPEN and GLIM criteria after being risk evaluated by Malnutrition Universal Screening Tool (MUST). Cumulative incidence curves were plotted for 30-day good outcomes in patients according to the ESPEN and GLIM criteria. Cox regression models were used to determine the factors associated with good outcomes in the univariate and multivariable analyses.
The prevalence of malnutrition defined by the GLIM criteria (22.8%) was higher than that defined by the ESPEN criteria (16.2%). Patients with malnutrition defined by the ESPEN and GLIM criteria had a significantly prolonged median length of hospital stay (LOS) after nutritionDay compared with non-malnutrition patients (8 days vs. 6 days, p < 0.001). Inpatients defined as nutritionally at-risk by the MUST or malnutrition defined by the ESPEN criteria and the GLIM criteria, and patients with pre-operative conditions, decreased mobility, prolonged LOS over three weeks before nutritionDay, as well as those receiving nutritional support had a reduced chance of good outcome.
The patients with nutritional risk or malnutrition and those who received nutritional support were significantly associated with decreased good 30-day outcomes, highlighting the necessity for standardized nutrition training in the healthcare setting.
本研究旨在根据全球营养不良领导倡议（GLIM）和欧洲临床营养与代谢学会（ESPEN）标准，调查住院中国患者的营养状况，并确定营养特征和营养支持对临床良好结局的影响。
纳入参与2010 - 2020年中国营养日调查的住院患者。通过营养不良通用筛查工具（MUST）进行风险评估后，根据ESPEN和GLIM标准定义营养不良。根据ESPEN和GLIM标准绘制患者30天良好结局的累积发病率曲线。在单变量和多变量分析中，使用Cox回归模型确定与良好结局相关的因素。
GLIM标准定义的营养不良患病率（22.8%）高于ESPEN标准定义的患病率（16.2%）。与非营养不良患者相比，根据ESPEN和GLIM标准定义为营养不良的患者在营养日后的中位住院时间显著延长（8天对6天，p < 0.001）。被MUST定义为营养风险或被ESPEN标准和GLIM标准定义为营养不良的住院患者，以及有术前状况、活动能力下降、营养日前住院时间超过三周的患者，以及接受营养支持的患者，良好结局的机会降低。
有营养风险或营养不良的患者以及接受营养支持的患者与30天良好结局降低显著相关，突出了在医疗环境中进行标准化营养培训的必要性。
