Abstract：
BACKGROUND: The aim of this study was to pilot a protocol for prospective validation of the Global Leadership Initiative on Malnutrition (GLIM) criteria in hospital patients and evaluate its feasibility and patient acceptability.
METHODS: The validation protocol follows the GLIM consortium\'s rigorous methodological guidance. Protocol feasibility was assessed against criteria on recruitment (≥50%) and data collection completion (≥80%); protocol acceptability was assessed via patient satisfaction surveys and interviews. Adult inpatients in a tertiary hospital underwent four nutrition assessments (each by a different assessor); two Subjective Global Assessments (SGAs) and two GLIM assessments. All five GLIM criteria were assessed with bioelectrical impedance analysis used for muscle mass. Interrater reliability, criterion validity, and predictive validity were reported to detect trends.
RESULTS: All primary feasibility criteria were met (consent rate 76%; data for GLIM criterion validity collected on 83% participants). Of predictive outcome data, 100% of hospital-related data, 82% of 6-month mortality data, and 39% of 6-month health-related quality of life data were collected. The mean (SD) age of participants was 61.0 ± 16.2 years, and 51.5% were male. The median (interquartile range) length of stay and body mass index were 7 (4-15) days and 25.6 (24.2-33.0) kg/m2, respectively. GLIM criteria diagnosed 70% of the patients as malnourished vs 55% with SGA. Most patients found the data collection acceptable with minimal burden.
CONCLUSIONS: The methods outlined in this rigorous GLIM validation protocol are feasible to undertake in hospitals and acceptable to patients. This paper provides practical methodological guidance for future prospective GLIM validation studies.
METHODS: The validation protocol follows the GLIM consortium\'s rigorous methodological guidance. Protocol feasibility was assessed against criteria on recruitment (≥50%) and data collection completion (≥80%); protocol acceptability was assessed via patient satisfaction surveys and interviews. Adult inpatients in a tertiary hospital underwent four nutrition assessments (each by a different assessor); two Subjective Global Assessments (SGAs) and two GLIM assessments. All five GLIM criteria were assessed with bioelectrical impedance analysis used for muscle mass. Interrater reliability, criterion validity, and predictive validity were reported to detect trends.
RESULTS: All primary feasibility criteria were met (consent rate 76%; data for GLIM criterion validity collected on 83% participants). Of predictive outcome data, 100% of hospital-related data, 82% of 6-month mortality data, and 39% of 6-month health-related quality of life data were collected. The mean (SD) age of participants was 61.0 ± 16.2 years, and 51.5% were male. The median (interquartile range) length of stay and body mass index were 7 (4-15) days and 25.6 (24.2-33.0) kg/m2, respectively. GLIM criteria diagnosed 70% of the patients as malnourished vs 55% with SGA. Most patients found the data collection acceptable with minimal burden.
CONCLUSIONS: The methods outlined in this rigorous GLIM validation protocol are feasible to undertake in hospitals and acceptable to patients. This paper provides practical methodological guidance for future prospective GLIM validation studies.
摘要：
背景：本研究的目的是在住院患者中对全球营养不良领导力倡议（GLIM）标准进行前瞻性验证，并评估其可行性和患者可接受性。
方法：验证方案遵循GLIM联盟严格的方法学指导。根据招募（≥50％）和数据收集完成（≥80％）的标准评估方案的可行性；通过患者满意度调查和访谈评估方案的可接受性。三级医院的成年住院患者接受了四次营养评估（每次由不同的评估者进行）；两次主观全球评估（SGA）和两次GLIM评估。用用于肌肉质量的生物电阻抗分析评估所有五个GLIM标准。Interrater可靠性，标准有效性，并报告预测效度以检测趋势。
结果：符合所有主要可行性标准（同意率为76％；收集了83％参与者的GLIM标准有效性数据）。在预测结果数据中，100%的医院相关数据，82%的6个月死亡率数据，39%的6个月健康相关生活质量数据被收集.参与者的平均年龄（SD）为61.0±16.2岁，51.5%为男性。中位（四分位距）住院时间和体重指数分别为7（4-15）天和25.6（24.2-33.0）kg/m2。GLIM标准诊断70％的患者营养不良，而SGA诊断为55％。大多数患者发现数据收集可以接受，负担最小。
结论：此严格的GLIM验证方案中概述的方法在医院中是可行的，并且为患者所接受。本文为未来的前瞻性GLIM验证研究提供了实用的方法学指导。
方法：验证方案遵循GLIM联盟严格的方法学指导。根据招募（≥50％）和数据收集完成（≥80％）的标准评估方案的可行性；通过患者满意度调查和访谈评估方案的可接受性。三级医院的成年住院患者接受了四次营养评估（每次由不同的评估者进行）；两次主观全球评估（SGA）和两次GLIM评估。用用于肌肉质量的生物电阻抗分析评估所有五个GLIM标准。Interrater可靠性，标准有效性，并报告预测效度以检测趋势。
结果：符合所有主要可行性标准（同意率为76％；收集了83％参与者的GLIM标准有效性数据）。在预测结果数据中，100%的医院相关数据，82%的6个月死亡率数据，39%的6个月健康相关生活质量数据被收集.参与者的平均年龄（SD）为61.0±16.2岁，51.5%为男性。中位（四分位距）住院时间和体重指数分别为7（4-15）天和25.6（24.2-33.0）kg/m2。GLIM标准诊断70％的患者营养不良，而SGA诊断为55％。大多数患者发现数据收集可以接受，负担最小。
结论：此严格的GLIM验证方案中概述的方法在医院中是可行的，并且为患者所接受。本文为未来的前瞻性GLIM验证研究提供了实用的方法学指导。
