Relationship between global leadership initiative on malnutrition (GLIM) defined malnutrition and survival, length of stay and post-operative complications in people with cancer: A systematic review.

Dylan Brown, Jenelle Loeliger, Jane Stewart, Kate L Graham, Sunita Goradia, Chantal Gerges, Shania Lyons, Molly Connor, Sam Stewart, Adrian Di Giovanni, Sarah D'Angelo, Nicole Kiss

Journal: Clinical nutrition (Edinburgh, Scotland) 2023;42(3):255-268

PMID: 36716618

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND & AIMS

The predictive validity of the GLIM criteria for survival, length of hospital stay (LOHS) and post-operative complications among people with cancer have not been systematically reviewed. This systematic review aims to determine whether GLIM malnutrition is predictive of these outcomes, and whether the predictive validity is affected by how phenotypic and etiologic criteria are assessed.

METHODS

Cohort studies published after 2018 were systematically reviewed according to PRISMA guidelines from Embase, Medline Complete and CINAHL Complete. Risk of bias and methodologic quality were assessed using the Journal of the Academy of Nutrition and Dietetics' Quality Criteria Checklist tool for Primary research.

RESULTS

In total, 21 studies were included, including 28,726 participants. All studies investigated survival, where 18 reported GLIM malnutrition is associated with decreased survival. LOHS was investigated in six studies, with all finding an association between GLIM malnutrition and longer LOHS. Post-operative complications were assessed in seven studies, of which five reported GLIM malnutrition was predictive of increased post-operative complications. Methods to assess the GLIM phenotypic and etiologic criteria varied, with consistent predictive ability for survival regardless of method of assessing reduced muscle mass. However, predictive ability was more variable across different measures of inflammation and reduced intake.

CONCLUSION

GLIM malnutrition was consistently predictive of worse clinical outcomes. Different measures of reduced muscle mass did not affect the predictive ability of GLIM for survival. However, variation in assessment of the etiologic criteria resulted in varying predictive ability of the GLIM diagnosis for survival.

Address: School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.; School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia; Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Australia.; Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Australia.; Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia; Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, Australia. Electronic address: [email protected].

DOI: 10.1016/j.clnu.2023.01.012

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MeSH Terms: Humans, Leadership, Length of Stay, Neoplasms, Malnutrition, Nutritional Status, Postoperative Complications, Nutrition Assessment