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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1438158

Validation of GLIM criteria for hospital malnutrition diagnosis by comparison of three different anthropometric approaches to evaluate reduced muscle mass. A prospective cohort study

Provisionally accepted
Mostafa Shahraki Jazinaki Mostafa Shahraki Jazinaki 1Mohammad Safarian Mohammad Safarian 1*Seyyed Mostafa Arabi Seyyed Mostafa Arabi 2Jamshid Jamali Jamshid Jamali 3Abdolreza Norouzy Abdolreza Norouzy 1*
  • 1 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  • 2 Non-Communicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
  • 3 Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

The final, formatted version of the article will be published soon.

    Background & Aims: The Global Leadership Initiative on Malnutrition (GLIM) recently proposed a new malnutrition diagnostic tool known as the GLIM criteria. The GLIM criteria need confirmed validation before being widely used in each population or healthcare system. This study aimed to investigate the validation of the GLIM criteria for malnutrition diagnosis in hospitalized patients. Methods: The content validity was assessed by calculating the content validity ratio (CVR) and content validity index (CVI). Subjective Global Assessment (SGA) is considered the reference tool to diagnose malnutrition in concurrent validation. Also, the Kudder-Richardson 20 was used to evaluate the reliability of the GLIM criteria. Furthermore, hospital mortality, length of hospitalization (LOS), prolonged hospital stays (LOS >6 days), 30-days hospital readmission, and 30- and 60-days mortality were identified as malnutrition-related outcomes in predictive validity. Results: A total of 332 adult/elderly hospitalized patients (median age: 58 (IQR: 24.7), 60.5% males) were enrolled to present the study. Appling GLIM criteria by considering the calf circumference < 31 cm in both genders or mid-upper arm (MUAC) < 23 cm in males and MUAC < 22 cm in females as reduced muscle mass had an appropriate accuracy (84.6%, 83.4%, respectively), good ability to distinguish malnourished patients (AUC ROC: 0.85, 0.83, respectively), satisfactory sensitivity (89.58%, 84.02%, respectively), and satisfactory specificity (81%, 83%, respectively) compared to the SGA tool. Furthermore, the reliability of the GLIM criteria for malnutrition diagnosis in hospitalized patients was acceptable in all 3 applied approaches (KR-20 > 0.5). The malnutrition diagnosed by GLIM criteria could significantly predict the odds of prolonged hospital stays, 30-days hospital readmission, and 60-days mortality, while it had no significant association with the risk of hospital mortality. Conclusion: The current study revealed that applying GLIM criteria had satisfactory validity in diagnosing hospital malnutrition in non-critically ill hospitalized patients.

    Keywords: Validation, The Global Leadership Initiative on Malnutrition, Nutritional assessment, Malnutrition, clinical outcomes

    Received: 25 May 2024; Accepted: 18 Nov 2024.

    Copyright: © 2024 Shahraki Jazinaki, Safarian, Arabi, Jamali and Norouzy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Mohammad Safarian, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
    Abdolreza Norouzy, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

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