Comparison of two screening tools in GLIM for the diagnosis of malnutrition in hospitalized elderly
ZHANG Qizhe1, SHEN Shanshan2, CHEN Xujiao2
1.The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China; 2.Department of Geriatrics, Zhejiang Hospital, Hangzhou 310030, China
ZHANG Qizhe,SHEN Shanshan,CHEN Xujiao. Comparison of two screening tools in GLIM for the diagnosis of malnutrition in hospitalized elderly[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(3): 194-198.
Abstract：Objective: To analyze the consistency of the results of different nutrition screening tools and different combinations of criteria in diagnosing malnutrition of the global leadership initiative on malnutrition (GLIM). Methods: A total of 130 elderly patients (≥65 years old) who were hospitalized in the Geriatrics Department of Zhejiang Hospital from June 2019 to June 2020 were retrospectively selected. The NRS2002 and other questionnaires were evaluated, and the patients with positive nutrition screening were diagnosed as malnutrition according to the second step of GLIM who met at least one etiological criterion and one clinical criterion. Kappa value analysis of the consistency of NRS2002 and MNA-SF as the first step of GLIM nutritional screening tool for diagnosing malnutrition and the consistency of the two etiological criteria combined with various clinical criteria respectively for diagnosing malnutrition. At the same time, the independent influencing factors of malnutrition were determined by Logistic regression analysis. Results: Using NRS2002 and MNA-SF as screening tools, 23(17.69%) and 25(19.23%) malnourished patients were finally diagnosed, with high consistency (Kappa=0.71, P<0.001). In malnutrition patients screened positive for both NRS2002 and MNA-SF, consistency in diagnosing malnutrition with the combination of involuntary weight loss and the two etiological criteria wasmoderate (Kappa=0.59, P=0.003), the diagnostic agreement between muscle loss and the respective variety of the two etiological criteria was also moderate (Kappa=0.51, P=0.007). However, low body mass index (BMI) was less consistent with the combination of the two etiological criteria (Kappa=0.26, P=0.188). In addition, logistic regression analysis showed that depression, insomnia were independent risk factor of malnutrition in elderly hospitalized patients (P<0.05). Conclusion: When NRS2002 and MNA-SF are used as the first screening tools of GLIM, the consistency of diagnosis of malnutrition is high, and they can be substituted for each other. In the standard combination of the second step of GLIM, meeting involuntary weight loss or muscle mass loss with each combination of the two etiological criteria was moderately consistent.
