PDF(Pubmed)
Abstract：
UNASSIGNED: The proposal of the global leadership initiative in malnutrition (GLIM) criteria has received great attention from clinicians. The criteria are mainly used in the research environment and have the potential to be widely used in the clinic in the future. However, the prevalence of malnutrition and risk of future malnutrition based on a current diagnosis of malnutrition are worth exploring.
UNASSIGNED: A systematic search of PubMed, Embase, and the Cochrane Library was performed from the earliest available date to 1 February 2023. According to the diagnostic criteria of the GLIM, we analysed the prevalence of malnutrition by directly adopting the GLIM criteria for diagnosis without a previous nutritional risk screening (one-step approach) and by adopting the GLIM criteria for diagnosis after a nutritional risk screening (two-step approach). The main outcome was the prevalence of malnutrition based on the one-and two-step approaches. Secondary outcomes were the future risk of malnutrition based on the GLIM diagnosis, including mortality within and beyond 1 year. primary outcomes were pooled using random-effects models, and secondary outcomes are presented as hazard ratios (HRs) and 95% confidence intervals (CIs).
UNASSIGNED: A total of 64 articles were included in the study, including a total of 47,654 adult hospitalized patients and 15,089 malnourished patients based on the GLIM criteria. Malnutrition was diagnosed by the one-step approach in 18 studies and by the two-step approach in 46 studies. The prevalence of malnutrition diagnosed by the one-and two-step approaches was 53% (95% CI, 42%-64%) and 39% (95% CI, 0.35%-0.43%), respectively. The prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was quite different; the prevalence of malnutrition diagnosed by the Nutritional Risk Screening 2002 (NRS2002) GLIM tool was 35% (95% CI, 29%-40%); however, the prevalence of malnutrition diagnosed by the Mini Nutrition Assessment (MNA) GLIM tool was 48% (95% CI, 35%-62%). Among the disease types, the prevalence of malnutrition in cancer patients was 44% (95% CI, 36%-52%), while that in acute and critically ill patients was 44% (95% CI, 33%-56%). The prevalence in patients in internal medicine wards was 40% (95% CI, 34%-45%), while that in patients in surgical wards was 47% (95% CI, 30%-64%). In addition, the mortality risk within 1 year (HR, 2.62; 95% CI, 1.95-3.52; I2 = 77.1%) and beyond 1 year (HR, 2.04; 95% CI, 1.70-2.45; I2 = 59.9%) of patients diagnosed with malnutrition by the GLIM criteria was double that of patients with normal nutrition.
UNASSIGNED: The prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was significantly lower than the prevalence of malnutrition diagnosed directly by the GLIM criteria. In addition, the mortality risk was significantly greater among malnourished patients assessed by the GLIM criteria.Systematic review registration: identifier CRD42023398454.
UNASSIGNED: A systematic search of PubMed, Embase, and the Cochrane Library was performed from the earliest available date to 1 February 2023. According to the diagnostic criteria of the GLIM, we analysed the prevalence of malnutrition by directly adopting the GLIM criteria for diagnosis without a previous nutritional risk screening (one-step approach) and by adopting the GLIM criteria for diagnosis after a nutritional risk screening (two-step approach). The main outcome was the prevalence of malnutrition based on the one-and two-step approaches. Secondary outcomes were the future risk of malnutrition based on the GLIM diagnosis, including mortality within and beyond 1 year. primary outcomes were pooled using random-effects models, and secondary outcomes are presented as hazard ratios (HRs) and 95% confidence intervals (CIs).
UNASSIGNED: A total of 64 articles were included in the study, including a total of 47,654 adult hospitalized patients and 15,089 malnourished patients based on the GLIM criteria. Malnutrition was diagnosed by the one-step approach in 18 studies and by the two-step approach in 46 studies. The prevalence of malnutrition diagnosed by the one-and two-step approaches was 53% (95% CI, 42%-64%) and 39% (95% CI, 0.35%-0.43%), respectively. The prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was quite different; the prevalence of malnutrition diagnosed by the Nutritional Risk Screening 2002 (NRS2002) GLIM tool was 35% (95% CI, 29%-40%); however, the prevalence of malnutrition diagnosed by the Mini Nutrition Assessment (MNA) GLIM tool was 48% (95% CI, 35%-62%). Among the disease types, the prevalence of malnutrition in cancer patients was 44% (95% CI, 36%-52%), while that in acute and critically ill patients was 44% (95% CI, 33%-56%). The prevalence in patients in internal medicine wards was 40% (95% CI, 34%-45%), while that in patients in surgical wards was 47% (95% CI, 30%-64%). In addition, the mortality risk within 1 year (HR, 2.62; 95% CI, 1.95-3.52; I2 = 77.1%) and beyond 1 year (HR, 2.04; 95% CI, 1.70-2.45; I2 = 59.9%) of patients diagnosed with malnutrition by the GLIM criteria was double that of patients with normal nutrition.
UNASSIGNED: The prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was significantly lower than the prevalence of malnutrition diagnosed directly by the GLIM criteria. In addition, the mortality risk was significantly greater among malnourished patients assessed by the GLIM criteria.Systematic review registration: identifier CRD42023398454.
摘要：
■全球营养不良领导倡议（GLIM）标准的提议受到了临床医生的极大关注。该标准主要用于研究环境，未来有可能在临床上广泛使用。然而,基于目前对营养不良的诊断,营养不良的患病率和未来营养不良的风险值得探讨.
■对PubMed的系统搜索，Embase,Cochrane图书馆从最早的可用日期到2023年2月1日进行。根据GLIM的诊断标准，我们通过直接采用GLIM诊断标准而不进行营养风险筛查(一步法)和在营养风险筛查后采用GLIM诊断标准(两步法)分析了营养不良的患病率.主要结果是基于一步法和两步法的营养不良患病率。次要结果是基于GLIM诊断的未来营养不良风险，包括1年内及以后的死亡率。主要结果使用随机效应模型进行汇总，次要结局以风险比(HR)和95%置信区间(CIs)表示.
■本研究共纳入64篇文章，根据GLIM标准，包括总共47,654名成人住院患者和15,089名营养不良患者。在18项研究中通过一步法诊断营养不良，在46项研究中通过两步法诊断营养不良。通过一步法和两步法诊断的营养不良患病率分别为53％（95％CI，42％-64％）和39％（95％CI，0.35％-0.43％），分别。营养风险筛查后由GLIM标准诊断的营养不良的患病率有很大的不同;营养风险筛查2002(NRS2002)GLIM工具诊断的营养不良患病率为35%(95%CI,29%-40%);然而,迷你营养评估(MNA)GLIM工具诊断的营养不良患病率为48%(95%CI,35%-62%).在疾病类型中，癌症患者营养不良的患病率为44%（95%CI，36%-52%），而在急性和危重患者中，这一比例为44%（95%CI，33%-56%）。内科病房患者的患病率为40％（95％CI，34％-45％），而在外科病房的患者中，这一比例为47%(95%CI，30%-64%)。此外,1年内的死亡风险(HR，2.62；95%CI，1.95-3.52；I2=77.1%）及超过1年（HR，2.04；95％CI，1.70-2.45；I2=59.9％）根据GLIM标准诊断为营养不良的患者是营养正常患者的两倍。
■营养风险筛查后，由GLIM标准诊断的营养不良患病率明显低于由GLIM标准直接诊断的营养不良患病率。此外,在GLIM标准评估的营养不良患者中,死亡风险显著更大.系统审查注册：标识符CRD42023398454。
■对PubMed的系统搜索，Embase,Cochrane图书馆从最早的可用日期到2023年2月1日进行。根据GLIM的诊断标准，我们通过直接采用GLIM诊断标准而不进行营养风险筛查(一步法)和在营养风险筛查后采用GLIM诊断标准(两步法)分析了营养不良的患病率.主要结果是基于一步法和两步法的营养不良患病率。次要结果是基于GLIM诊断的未来营养不良风险，包括1年内及以后的死亡率。主要结果使用随机效应模型进行汇总，次要结局以风险比(HR)和95%置信区间(CIs)表示.
■本研究共纳入64篇文章，根据GLIM标准，包括总共47,654名成人住院患者和15,089名营养不良患者。在18项研究中通过一步法诊断营养不良，在46项研究中通过两步法诊断营养不良。通过一步法和两步法诊断的营养不良患病率分别为53％（95％CI，42％-64％）和39％（95％CI，0.35％-0.43％），分别。营养风险筛查后由GLIM标准诊断的营养不良的患病率有很大的不同;营养风险筛查2002(NRS2002)GLIM工具诊断的营养不良患病率为35%(95%CI,29%-40%);然而,迷你营养评估(MNA)GLIM工具诊断的营养不良患病率为48%(95%CI,35%-62%).在疾病类型中，癌症患者营养不良的患病率为44%（95%CI，36%-52%），而在急性和危重患者中，这一比例为44%（95%CI，33%-56%）。内科病房患者的患病率为40％（95％CI，34％-45％），而在外科病房的患者中，这一比例为47%(95%CI，30%-64%)。此外,1年内的死亡风险(HR，2.62；95%CI，1.95-3.52；I2=77.1%）及超过1年（HR，2.04；95％CI，1.70-2.45；I2=59.9％）根据GLIM标准诊断为营养不良的患者是营养正常患者的两倍。
■营养风险筛查后，由GLIM标准诊断的营养不良患病率明显低于由GLIM标准直接诊断的营养不良患病率。此外,在GLIM标准评估的营养不良患者中,死亡风险显著更大.系统审查注册：标识符CRD42023398454。
