Standardising and simplifying the Global Leadership Initiative on Malnutrition (GLIM) for its more general application.
GLIM criteria
Malnutrition
Muscle mass
Nutrition assessment
Nutrition screening
Screening tools
Journal
Clinical nutrition ESPEN
ISSN: 2405-4577
Titre abrégé: Clin Nutr ESPEN
Pays: England
ID NLM: 101654592
Informations de publication
Date de publication:
Aug 2024
Aug 2024
Historique:
received:
17
10
2023
revised:
27
04
2024
accepted:
15
05
2024
medline:
21
6
2024
pubmed:
21
6
2024
entrez:
20
6
2024
Statut:
ppublish
Résumé
Malnutrition is present in 20-50% of hospital patients but its recognition is often neither timely nor complete. The Global Leadership Initiative on Malnutrition (GLIM) aims to improve this, but its successful implementation may be compromised by its dependence on (a choice of) prior screening tools and difficulties in consistent assessment of muscle mass. To explore different approaches to screening and muscle assessment in GLIM and to offer simpler choices for its more widespread application. (1) Data from 300 consenting in-patients provided Nutritional Risk Screening (NRS-2002), Malnutrition Universal Screening Tool (MUST), and Subjective Global Assessment (SGA) scores. GLIM scoring was preceded by NRS-2002 or MUST (using threshold scores of 1 or 2 for MUST), or no prior screening. The results of GLIM scoring preceded by different screening approaches were compared with those of SGA. (2) The literature on mid-upper arm circumference (MUAC) and calf circumference (CC) as simple, non-invasive, objective methods of muscle assessment methods was reviewed (3) The cumulative times taken to obtain GLIM scores were measured and corrected for the different screening strategies. (1) Participants' mean age was 60 years, 157 (52%) were female and mean BMI was 27.8 kg/m Preceding GLIM by screening can decrease its sensitivity and increase overall time utilisation; "gold standard" muscle assessment is not globally accessible. Our results therefore support considering using GLIM as a combined screening and assessment tool, with MUAC as the method of muscle assessment which can be supplemented by technical approaches if available and deemed necessary. This could potentially both simplify the use of GLIM and improve the early detection of malnutrition. ∗Indicates statistically significant difference from use of GLIM without prior screening.
Sections du résumé
BACKGROUND
BACKGROUND
Malnutrition is present in 20-50% of hospital patients but its recognition is often neither timely nor complete. The Global Leadership Initiative on Malnutrition (GLIM) aims to improve this, but its successful implementation may be compromised by its dependence on (a choice of) prior screening tools and difficulties in consistent assessment of muscle mass.
AIMS
OBJECTIVE
To explore different approaches to screening and muscle assessment in GLIM and to offer simpler choices for its more widespread application.
METHODS
METHODS
(1) Data from 300 consenting in-patients provided Nutritional Risk Screening (NRS-2002), Malnutrition Universal Screening Tool (MUST), and Subjective Global Assessment (SGA) scores. GLIM scoring was preceded by NRS-2002 or MUST (using threshold scores of 1 or 2 for MUST), or no prior screening. The results of GLIM scoring preceded by different screening approaches were compared with those of SGA. (2) The literature on mid-upper arm circumference (MUAC) and calf circumference (CC) as simple, non-invasive, objective methods of muscle assessment methods was reviewed (3) The cumulative times taken to obtain GLIM scores were measured and corrected for the different screening strategies.
RESULTS
RESULTS
(1) Participants' mean age was 60 years, 157 (52%) were female and mean BMI was 27.8 kg/m
CONCLUSIONS
CONCLUSIONS
Preceding GLIM by screening can decrease its sensitivity and increase overall time utilisation; "gold standard" muscle assessment is not globally accessible. Our results therefore support considering using GLIM as a combined screening and assessment tool, with MUAC as the method of muscle assessment which can be supplemented by technical approaches if available and deemed necessary. This could potentially both simplify the use of GLIM and improve the early detection of malnutrition. ∗Indicates statistically significant difference from use of GLIM without prior screening.
Identifiants
pubmed: 38901933
pii: S2405-4577(24)00129-3
doi: 10.1016/j.clnesp.2024.05.010
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
120-127Informations de copyright
Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None of the authors has any specific conflicts of interest to declare. Participating in the study formed part of the coursework of CK-B, GK and AL towards the University of Tartu Masters in Clinical Nutrition.