Comparative analysis of malnutrition screening tools in predicting mortality in critically ill patients: SGA, GLIM, and mNutric Score.
DOI:
https://doi.org/10.12873/451liemPalabras clave:
Malnutrition, ICU, mNutric Score, SGA, GLIM, mortalityResumen
Introduction: Malnutrition is prevalent among critically ill patients and is associated with increased mortality, prolonged hospital stays, and higher rates of complications. Several malnutrition screening tools are available, including the Subjective Global Assessment (SGA), the Global Leadership Initiative on Malnutrition (GLIM), and the modified Nutrition Risk in Critically Ill (mNutric) Score. This study aims to compare the predictive ability of these three tools in determining mortality among critically ill patients.
Methods: A retrospective cohort study was conducted in the Intensive Care Unit (ICU) of RSUP Dr. Wahidin Sudirohusodo from April 2022 to March 2023. Patients aged 18 years and older were included. Nutritional status was assessed using SGA, GLIM, and mNutric Score. The primary outcome was mortality.
Result: A total of 1,106 patients were included in the analysis. The overall ICU mortality rate was 23.1%. The mNutric Score was a significant independent predictor of mortality (OR = 6.601, 95% CI: 4.183–10.416, p < 0.001), while neither SGA nor GLIM were significant after adjustment for confounders.
Conclusion: The mNutric Score is a superior tool for predicting mortality in critically ill patients compared to SGA and GLIM. Its use should be considered in ICU settings to identify patients at nutritional risk and guide timely interventions.
Citas
Sharma K, Mogensen KM, Robinson MK. Pathophysiology of Critical Illness and Role of Nutrition. Nutrition in Clinical Practice. 2019 Feb 23;34(1):12–22.
Cattani A, Eckert IC, Brito JE, Tartari RF, Silva FM. Nutritional risk in critically ill patients: how it is assessed, its prevalence and prognostic value: a systematic review. Nutr Rev. 2020 Dec 1;78(12):1052–68.
Kopp Lugli A, de Watteville A, Hollinger A, Goetz N, Heidegger C. Medical Nutrition Therapy in Critically Ill Patients Treated on Intensive and Intermediate Care Units: A Literature Review. J Clin Med. 2019 Sep 6;8(9):1395.
van Zanten ARH, De Waele E, Wischmeyer PE. Nutrition therapy and critical illness: practical guidance for the ICU, post-ICU, and long-term convalescence phases. Crit Care. 2019 Dec 21;23(1):368.
Domenech-Briz V, Gea-Caballero V, Czapla M, Chover-Sierra E, Juárez-Vela R, Santolalla Arnedo I, et al. Importance of nutritional assessment tools in the critically ill patient: A systematic review. Front Nutr. 2023 Jan 30;9.
Gonzalez MC, Bielemann RM, Kruschardt PP, Orlandi SP. Complementarity of NUTRIC score and Subjective Global Assessment for predicting 28-day mortality in critically ill patients. Clinical Nutrition. 2019 Dec;38(6):2846–50.
Gattermann Pereira T, da Silva Fink J, Tosatti JAG, Silva FM. Subjective Global Assessment Can Be Performed in Critically Ill Surgical Patients as a Predictor of Poor Clinical Outcomes. Nutrition in Clinical Practice. 2019 Feb 2;34(1):131–6.
Shahbazi S, Hajimohammadebrahim-Ketabforoush M, Vahdat Shariatpanahi M, Shahbazi E, Vahdat Shariatpanahi Z. The validity of the global leadership initiative on malnutrition criteria for diagnosing malnutrition in critically ill patients with COVID-19: A prospective cohort study. Clin Nutr ESPEN. 2021 Jun;43:377–82.
Díaz G, T.D. Correia MI, Gonzalez MC, Reyes M. The global leadership initiative on malnutrition criteria for the diagnosis of malnutrition in patients admitted to the intensive care unit: A systematic review and meta-analysis. Clinical Nutrition. 2023 Feb;42(2):182–9.
Brascher JMM, Peres WAF, Padilha PC. Use of the modified “Nutrition Risk in the critically ill” score and its association with the death of critically ill patients. Clin Nutr ESPEN. 2020 Feb;35:162–6.
Rattanachaiwong S, Zribi B, Kagan I, Theilla M, Heching M, Singer P. Comparison of nutritional screening and diagnostic tools in diagnosis of severe malnutrition in critically ill patients. Clinical Nutrition. 2020 Nov;39(11):3419–25.
Lee Z, Heyland DK. Determination of Nutrition Risk and Status in Critically Ill Patients: What Are Our Considerations? Nutrition in Clinical Practice. 2019 Feb 23;34(1):96–111.
Vavruk AM, Martins C, Mazza do Nascimento M. Validation of Malnutrition Clinical Characteristics in Critically Ill Patients. Nutrition in Clinical Practice. 2021 Oct 9;36(5):993–1002.
Acehan S, Gulen M, Isıkber C, Unlu N, Sumbul HE, Gulumsek E, et al. mNUTRIC tool is capable to predict nutritional needs and mortality early in patients suffering from severe pneumonia. Clin Nutr ESPEN. 2021 Oct;45:184–91.
Wang N, Wang MP, Jiang L, Du B, Zhu B, Xi XM. Association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score and clinical outcomes in the intensive care unit: a secondary analysis of a large prospective observational study. BMC Anesthesiol. 2021 Dec 8;21(1):220.
Theilla M, Rattanachaiwong S, Kagan I, Rigler M, Bendavid I, Singer P. Validation of GLIM malnutrition criteria for diagnosis of malnutrition in ICU patients: An observational study. Clinical Nutrition. 2021 May;40(5):3578–84.
Descargas
Publicado
Cómo citar
Número
Sección
Categorías
Licencia
Derechos de autor 2025 Nutrición Clínica y Dietética Hospitalaria
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Los lectores pueden utilizar los textos publicados de acuerdo con la definición BOAI (Budapest Open Access Initiative)