Predictive Capacity of GLIM vs mNUTRIC Score on Mortality in ICU Patients: A Cohort Study
DOI:
https://doi.org/10.12873/444chavarriaKeywords:
Mortality, Intensive Care Unit, GLIM, mNUTRIC,, MalnutritionAbstract
Introduction
Malnutrition in the ICU increases mortality, so it is essential to identify nutritional risks using validated tools. In 2021, the GLIM consensus was introduced to diagnose malnutrition in the ICU, showing a sensitivity of 85% and a specificity of 79%. However, its ability to predict mortality there has not yet been determined.
Objective
Determine the prognostic capacity of the GLIM criteria for mortality in ICU patients.
Materials and Methods
A cohort study was conducted with 101 ICU patients. Exclusions were made for patients with incomplete records, contagious infections, edema in lower limbs, or without lower limbs.
Results
Among patients with high nutritional risk according to mNUTRIC, 41.66% (n=5) died. mNUTRIC showed a significant association between nutritional risk and mortality (41.66% versus 3.3%, HR=8.181, Log Rank <0.001).
In contrast, 8.47% (n=5) of malnourished patients according to GLIM died. Malnutrition according to GLIM did not show a significant association with mortality compared to patients with normal nutritional status (8.47% versus 5.17%, HR=1.56, Log Rank=0.5351), indicating a discrepancy in the predictive capacity for mortality between the two tools.
Discussion
The discrepancy in the predictive capacity for mortality between the mNUTRIC and GLIM in ICU patients is notable. Milanez et al. (2023) also reported no significant association between malnutrition diagnosis according to GLIM and ICU mortality (OR=1.553, CI 0.944-2.553, p=0.115). This difference may be due to several factors: differences in study populations, variability in the specificity and sensitivity of GLIM, and the diagnostic criteria, as mNUTRIC includes severity and inflammatory status parameters.
Conclusions
The GLIM criteria did not prove to be an effective prognostic tool for mortality.
Keywords
Mortality, Intensive Care Unit, GLIM, mNUTRIC, Malnutrition
Abbreviations
ICU: Intensive Care Unit, GLIM: Global Leadership Initiative on Malnutrition, mNUTRIC: modified Nutrition Risk in the Critically Ill.
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