TY - JOUR
T1 - The ability of the Global Leadership Initiative on Malnutrition (GLIM) to diagnose protein-energy malnutrition in patients requiring vascular surgery
T2 - A validation study
AU - Thomas, Jolene
AU - Delaney, Christopher
AU - Miller, Michelle
PY - 2022
Y1 - 2022
N2 - Identifying nutritional deficits and implementing appropriate interventions in patients requiring vascular surgery is challenging due to the paucity of appropriate screening and assessment tools in this group. This retrospective study aimed to determine the validity of the Global Leadership Initiative on Malnutrition (GLIM) in identifying protein-energy malnutrition in inpatients admitted to a vascular surgery unit, using the PG-SGA as the comparator. Diagnostic accuracy and consistency were determined between the GLIM and the PG-SGA global rating. The GLIM determination was made retrospectively using the relevant parameters collected at baseline in the original study. Two hundred and twenty-four (70.1% male) participants were included. The prevalence of protein-energy malnutrition was 28.6% on GLIM and 17% via the PG-SGA. Compared with the PG-SGA, the GLIM achieved sensitivity of 73.7% and specificity of 80.6%, however positive predictive value was 43.7% indicating that the GLIM over-diagnosed malnutrition compared to the PG-SGA. Kappa reached 0.427 indicating moderate diagnostic consistency. Due to the absence of an ideal instrument and the complexity of malnutrition often seen in this group which extends beyond protein-energy malnutrition to significant micronutrient deficiencies, further work is required to determine the most appropriate instrument in this patient group, and how micronutrient status can also be included in the overall assessment given the critical role of micronutrients in this group.
AB - Identifying nutritional deficits and implementing appropriate interventions in patients requiring vascular surgery is challenging due to the paucity of appropriate screening and assessment tools in this group. This retrospective study aimed to determine the validity of the Global Leadership Initiative on Malnutrition (GLIM) in identifying protein-energy malnutrition in inpatients admitted to a vascular surgery unit, using the PG-SGA as the comparator. Diagnostic accuracy and consistency were determined between the GLIM and the PG-SGA global rating. The GLIM determination was made retrospectively using the relevant parameters collected at baseline in the original study. Two hundred and twenty-four (70.1% male) participants were included. The prevalence of protein-energy malnutrition was 28.6% on GLIM and 17% via the PG-SGA. Compared with the PG-SGA, the GLIM achieved sensitivity of 73.7% and specificity of 80.6%, however positive predictive value was 43.7% indicating that the GLIM over-diagnosed malnutrition compared to the PG-SGA. Kappa reached 0.427 indicating moderate diagnostic consistency. Due to the absence of an ideal instrument and the complexity of malnutrition often seen in this group which extends beyond protein-energy malnutrition to significant micronutrient deficiencies, further work is required to determine the most appropriate instrument in this patient group, and how micronutrient status can also be included in the overall assessment given the critical role of micronutrients in this group.
KW - GLIM
KW - Global Leadership Initiative on Malnutrition
KW - malnutrition
KW - validation
KW - vascular surgery
UR - http://www.scopus.com/inward/record.url?scp=85124755150&partnerID=8YFLogxK
U2 - 10.1017/S0007114522000344
DO - 10.1017/S0007114522000344
M3 - Article
C2 - 35115059
AN - SCOPUS:85124755150
JO - British Journal of Nutrition
JF - British Journal of Nutrition
SN - 0007-1145
ER -