We performed a retrospective cohort study of 257 adult outpatients with UWL. The GLIM criteria and SGA agreement were reported using the Cohen kappa coefficient. Kaplan-Meier survival curves and adjusted Cox regression analyses were used for survival data. Logistic regression was used for the other correlation analysis.
This study collected data from 257 patients for 2 years. Based on the GLIM criteria and SGA, malnutrition prevalence was 79.0% and 72.0%, respectively (κ = 0.728, P < 0.001). Using the SGA as a standard, GLIM had a sensitivity of 97.8%, a specificity of 69.4%, a positive predictive value of 89.2%, and a negative predictive value of 92.6%. Malnutrition was associated with higher rates of unplanned hospital admission independent of other prognostic factors (GLIM: hazard ratio [HR]=2.85, 95% CI=1.22-6.68; SGA: HR=2.07, 95% CI=1.13-3.79). Of the five GLIM criteria-related diagnostic combinations, disease burden or inflammation was the most important to predict unplanned hospital admission in multivariable analysis (HR=3.27, 95% CI=2.03-5.28).
There was good agreement between the GLIM criteria and the SGA. GLIM-defined malnutrition, as well as all five GLIM criteria-related diagnosis combinations, had the potential to predict unplanned hospital admissions in outpatients with UWL within 2 years.
方法:我们对257例成人UWL门诊患者进行了一项回顾性队列研究。GLIM标准和SGA协议使用科恩卡帕系数报告。Kaplan-Meier存活曲线和校正Cox回归分析用于生存数据。其他相关性分析采用Logistic回归分析。
结果:本研究收集了257名患者2年的数据。根据GLIM标准和SGA,营养不良患病率分别为79.0%和72.0%,(k=0.728,P<0.001)。使用SGA作为标准,GLIM的灵敏度为97.8%,特异性为69.4%,阳性预测值为89.2%,阴性预测值为92.6%。与其他预后因素无关,营养不良与计划外入院率较高相关(GLIM:风险比(HR)2.85,95%置信区间(CI):1.22至6.68;SGA:HR2.07,95%CI:1.13至3.79)。在与GLIM标准相关的五种诊断组合中,在多变量分析中,疾病负担或炎症是预测非计划性住院的最重要因素(HR3.27,95%CI:2.03~5.28).
结论:GLIM标准和SGA之间有很好的一致性。GLIM定义的营养不良,以及所有五个与GLIM标准相关的诊断组合,有可能预测2年内UWL门诊患者的计划外住院。本文受版权保护。保留所有权利。