PDF(Pubmed)
Abstract：
Neurocritically ill patients frequently exhibit coma, gastroparesis, and intense catabolism, leading to an increased risk of malnutrition. The Global Leadership Initiative on Malnutrition (GLIM) criteria for the diagnosis of malnutrition was created to achieve a consistent malnutrition diagnosis across diverse populations. This study aimed to validate the concurrent and predictive validity of GLIM criteria in patients with neurocritical illnesses. A total of 135 participants were followed from admission to the neurocritical unit (NCU) until discharge. Comparing GLIM criteria to the Subjective Global Assessment (SGA), sensitivity was 0.95 and specificity was 0.69. Predictive validity of GLIM criteria was assessed using a composite adverse clinical outcome, comprising mortality and various major complications. Adjusted hazard ratios for moderate and severe malnutrition were 2.86 (95% CI 1.45-5.67) and 3.88 (95% CI 1.51-9.94), respectively. Changes in indicators of nutritional status, including skeletal muscle mass and abdominal fat mass, within 7 days of admission were obtained for 61 participants to validate the predictive capability of the GLIM criteria for the patients\' response of standardized nutritional support. The GLIM criteria have a statistically significant predictive validity on changes in rectus femoris muscle thickness and midarm muscle circumference. In conclusion, the GLIM criteria demonstrate high sensitivity for diagnosing malnutrition in neurocritically ill patients and exhibit good predictive validity.
摘要：
神经危重患者经常表现为昏迷，胃轻瘫,和强烈的分解代谢，导致营养不良的风险增加。建立了营养不良诊断的全球领导力倡议（GLIM）标准，以在不同人群中实现一致的营养不良诊断。这项研究旨在验证GLIM标准在神经危重患者中的并发和预测有效性。共有135名参与者从入院到神经关键单元（NCU）直到出院。将GLIM标准与主观全球评估(SGA)进行比较，敏感性为0.95,特异性为0.69.使用复合不良临床结果评估GLIM标准的预测有效性，包括死亡率和各种主要并发症。中度和重度营养不良的调整风险比分别为2.86（95％CI1.45-5.67）和3.88（95％CI1.51-9.94），分别。营养状况指标的变化，包括骨骼肌和腹部脂肪，对61名参与者在入院后7天内进行了研究,以验证GLIM标准对患者接受标准化营养支持的反应的预测能力.GLIM标准对股直肌厚度和中臂肌围的变化具有统计学上显着的预测有效性。总之,GLIM标准对神经危重患者的营养不良诊断具有很高的敏感性,并表现出良好的预测效度.
