Abstract：
This study aimed to assess malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria and Subjective Global Assessment (SGA) at baseline and determine the GLIM criteria that best predicted unplanned hospitalization in outpatients with unintentional weight loss (UWL).
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.
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.
摘要：
背景：本研究旨在在基线时使用全球领导营养不良倡议（GLIM）标准和主观全球评估（SGA）评估营养不良，并确定最佳预测意外体重减轻（UWL）门诊患者计划外住院的GLIM标准。
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。
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。
