Abstract：
BACKGROUND: The present study aims to assess the interrater reliability of the Global Leadership Initiative on Malnutrition (GLIM) criteria, a framework to provide a consensus diagnosis of malnutrition. We also aimed to investigate its concurrent and predictive validity in the context of patients with cancer admitted to the intensive care unit (ICU).
METHODS: Individuals aged ≥19 years with cancer who were admitted to the ICU within 48 h of their initial hospital admission were included. Nutrition status was assessed with the Nutritional Risk Screening 2002, the Subjective Global Assessment (SGA), and the GLIM criteria. Interrater reliability was assessed by the kappa test (>0.80). The SGA served as the established benchmark for assessing concurrent validity. To evaluate predictive validity, the occurrence of mortality within 30 days was the outcome, and Cox regression models were applied.
RESULTS: A total of 212 patients were included: 66.9% were at nutrition risk, and 45.8% were malnourished according to the SGA. According to the GLIM criteria, 68.4% and 66% were identified as malnourished by evaluators 1 and 2, respectively (κ = 0.947; P < 0.001). The GLIM combination incorporating weight loss and the presence of inflammation exhibited sensitivity (82.4%) and specificity (92%). In the multivariate Cox regression models, most GLIM combinations emerged as independent predictors of complications.
CONCLUSIONS: The GLIM criteria demonstrated satisfactory interrater reliability, and the combination involving weight loss and the presence of inflammation exhibited noteworthy sensitivity and specificity. Most GLIM combinations emerged as independent predictors of 30-day mortality.
METHODS: Individuals aged ≥19 years with cancer who were admitted to the ICU within 48 h of their initial hospital admission were included. Nutrition status was assessed with the Nutritional Risk Screening 2002, the Subjective Global Assessment (SGA), and the GLIM criteria. Interrater reliability was assessed by the kappa test (>0.80). The SGA served as the established benchmark for assessing concurrent validity. To evaluate predictive validity, the occurrence of mortality within 30 days was the outcome, and Cox regression models were applied.
RESULTS: A total of 212 patients were included: 66.9% were at nutrition risk, and 45.8% were malnourished according to the SGA. According to the GLIM criteria, 68.4% and 66% were identified as malnourished by evaluators 1 and 2, respectively (κ = 0.947; P < 0.001). The GLIM combination incorporating weight loss and the presence of inflammation exhibited sensitivity (82.4%) and specificity (92%). In the multivariate Cox regression models, most GLIM combinations emerged as independent predictors of complications.
CONCLUSIONS: The GLIM criteria demonstrated satisfactory interrater reliability, and the combination involving weight loss and the presence of inflammation exhibited noteworthy sensitivity and specificity. Most GLIM combinations emerged as independent predictors of 30-day mortality.
摘要：
背景：本研究旨在评估全球营养不良领导力倡议（GLIM）标准的评估者之间的可靠性，提供营养不良共识诊断的框架。我们还旨在研究其在重症监护病房（ICU）收治的癌症患者中的并发和预测有效性。
方法：纳入年龄≥19岁的癌症患者，在初次入院48小时内入住ICU。营养状况通过2002年营养风险筛查、主观全球评估(SGA)进行评估，和GLIM标准。通过kappa检验(>0.80)评估评分者间的可靠性。SGA是评估并发有效性的既定基准。为了评估预测效度，30天内死亡的发生是结果，并应用Cox回归模型。
结果：共纳入212例患者：66.9%有营养风险，根据SGA，45.8%营养不良。根据GLIM标准，评估者1和2分别确定了68.4％和66％的营养不良（κ=0.947；P<0.001）。结合体重减轻和炎症存在的GLIM组合表现出敏感性(82.4%)和特异性(92%)。在多元Cox回归模型中，大多数GLIM组合是并发症的独立预测因子.
结论：GLIM标准证明了令人满意的评分者间可靠性，涉及体重减轻和炎症的组合表现出值得注意的敏感性和特异性。大多数GLIM组合是30天死亡率的独立预测因子。
方法：纳入年龄≥19岁的癌症患者，在初次入院48小时内入住ICU。营养状况通过2002年营养风险筛查、主观全球评估(SGA)进行评估，和GLIM标准。通过kappa检验(>0.80)评估评分者间的可靠性。SGA是评估并发有效性的既定基准。为了评估预测效度，30天内死亡的发生是结果，并应用Cox回归模型。
结果：共纳入212例患者：66.9%有营养风险，根据SGA，45.8%营养不良。根据GLIM标准，评估者1和2分别确定了68.4％和66％的营养不良（κ=0.947；P<0.001）。结合体重减轻和炎症存在的GLIM组合表现出敏感性(82.4%)和特异性(92%)。在多元Cox回归模型中，大多数GLIM组合是并发症的独立预测因子.
结论：GLIM标准证明了令人满意的评分者间可靠性，涉及体重减轻和炎症的组合表现出值得注意的敏感性和特异性。大多数GLIM组合是30天死亡率的独立预测因子。
