Abstract：
Malnutrition is associated with a high risk of morbidity and mortality in patients with critical illness. The nutrition status of patients in the intensive care unit (ICU) is challenging to assess. The Global Leadership Initiative on Malnutrition (GLIM) is a novel framework used for the diagnosis of malnutrition. However, its efficacy in patients with critical illness in the ICU has not been validated.
To investigate the use and validity of the GLIM criteria in adult patients admitted to the ICU.
A systematic review and meta-analysis were performed, and seven databases were searched for relevant studies. The selection criteria included studies that used the GLIM in adult patients admitted to the ICU. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
Five studies were included in the analysis. Approximately 15%-68% of patients were diagnosed with malnutrition using the GLIM criteria. Meanwhile, 48%-75% of patients with malnutrition were identified with the Subjective Global Assessment (SGA). The inflammation criterion was easily adjudicated due to critical status, and three studies compared the GLIM and the SGA. According to the QUADAS-2 tool, the nutritional assessment process was not explicit in the studies. The meta-analysis had an overall sensitivity of 65.3% (95% CI: 34.9%-86.9%) and an overall specificity of 88.8% (95% CI: 58.1%-97.8%). In the prospective validation, malnutrition assessed by the GLIM criteria, and the SGA was associated with mortality. However, the association between length of hospital stay and mechanical ventilation was unclear.
The use and validity of the GLIM criteria among patients admitted to the ICU is still limited. Moreover, some concurrent and predictive validation studies have methodological limitations. Further studies must be performed to validate the use of the GLIM criteria in the ICU.
To investigate the use and validity of the GLIM criteria in adult patients admitted to the ICU.
A systematic review and meta-analysis were performed, and seven databases were searched for relevant studies. The selection criteria included studies that used the GLIM in adult patients admitted to the ICU. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
Five studies were included in the analysis. Approximately 15%-68% of patients were diagnosed with malnutrition using the GLIM criteria. Meanwhile, 48%-75% of patients with malnutrition were identified with the Subjective Global Assessment (SGA). The inflammation criterion was easily adjudicated due to critical status, and three studies compared the GLIM and the SGA. According to the QUADAS-2 tool, the nutritional assessment process was not explicit in the studies. The meta-analysis had an overall sensitivity of 65.3% (95% CI: 34.9%-86.9%) and an overall specificity of 88.8% (95% CI: 58.1%-97.8%). In the prospective validation, malnutrition assessed by the GLIM criteria, and the SGA was associated with mortality. However, the association between length of hospital stay and mechanical ventilation was unclear.
The use and validity of the GLIM criteria among patients admitted to the ICU is still limited. Moreover, some concurrent and predictive validation studies have methodological limitations. Further studies must be performed to validate the use of the GLIM criteria in the ICU.
摘要：
背景：在危重病患者中，营养不良与高发病率和死亡率相关。重症监护病房（ICU）患者的营养状况难以评估。全球营养不良领导倡议（GLIM）是用于诊断营养不良的新框架。然而,其在ICU危重症患者中的疗效尚未得到验证.
目的：探讨GLIM标准在ICU成年患者中的应用和有效性。
方法：进行系统评价和荟萃分析，并搜索了七个数据库进行相关研究。选择标准包括在入住ICU的成年患者中使用GLIM的研究。使用诊断准确性研究质量评估（QUADAS-2）工具进行质量评估。
结果：分析中包括5项研究。大约15%-68%的患者使用GLIM标准被诊断为营养不良。同时,通过主观整体评估（SGA）确定了48％-75％的营养不良患者。由于处于危急状态，炎症标准很容易裁定，三项研究比较了GLIM和SGA。根据QUADAS-2工具，研究中没有明确的营养评估过程.荟萃分析的总体敏感性为65.3%（95%CI：34.9%-86.9%），总体特异性为88.8%（95%CI：58.1%-97.8%）。在前瞻性验证中，根据GLIM标准评估的营养不良，SGA与死亡率相关。然而,住院时间与机械通气之间的关联尚不清楚.
结论：GLIM标准在ICU患者中的使用和有效性仍然有限。此外，一些并行和预测性验证研究存在方法学局限性.必须进行进一步的研究以验证GLIM标准在ICU中的使用。
目的：探讨GLIM标准在ICU成年患者中的应用和有效性。
方法：进行系统评价和荟萃分析，并搜索了七个数据库进行相关研究。选择标准包括在入住ICU的成年患者中使用GLIM的研究。使用诊断准确性研究质量评估（QUADAS-2）工具进行质量评估。
结果：分析中包括5项研究。大约15%-68%的患者使用GLIM标准被诊断为营养不良。同时,通过主观整体评估（SGA）确定了48％-75％的营养不良患者。由于处于危急状态，炎症标准很容易裁定，三项研究比较了GLIM和SGA。根据QUADAS-2工具，研究中没有明确的营养评估过程.荟萃分析的总体敏感性为65.3%（95%CI：34.9%-86.9%），总体特异性为88.8%（95%CI：58.1%-97.8%）。在前瞻性验证中，根据GLIM标准评估的营养不良，SGA与死亡率相关。然而,住院时间与机械通气之间的关联尚不清楚.
结论：GLIM标准在ICU患者中的使用和有效性仍然有限。此外，一些并行和预测性验证研究存在方法学局限性.必须进行进一步的研究以验证GLIM标准在ICU中的使用。
