The predictive validity of the GLIM criteria for survival, length of hospital stay (LOHS) and post-operative complications among people with cancer have not been systematically reviewed. This systematic review aims to determine whether GLIM malnutrition is predictive of these outcomes, and whether the predictive validity is affected by how phenotypic and etiologic criteria are assessed.
Cohort studies published after 2018 were systematically reviewed according to PRISMA guidelines from Embase, Medline Complete and CINAHL Complete. Risk of bias and methodologic quality were assessed using the Journal of the Academy of Nutrition and Dietetics\' Quality Criteria Checklist tool for Primary research.
In total, 21 studies were included, including 28,726 participants. All studies investigated survival, where 18 reported GLIM malnutrition is associated with decreased survival. LOHS was investigated in six studies, with all finding an association between GLIM malnutrition and longer LOHS. Post-operative complications were assessed in seven studies, of which five reported GLIM malnutrition was predictive of increased post-operative complications. Methods to assess the GLIM phenotypic and etiologic criteria varied, with consistent predictive ability for survival regardless of method of assessing reduced muscle mass. However, predictive ability was more variable across different measures of inflammation and reduced intake.
GLIM malnutrition was consistently predictive of worse clinical outcomes. Different measures of reduced muscle mass did not affect the predictive ability of GLIM for survival. However, variation in assessment of the etiologic criteria resulted in varying predictive ability of the GLIM diagnosis for survival.

UNASSIGNED: Recently, some cohorts have looked into the use of Global Leadership Initiative on Malnutrition (GLIM) criteria in cancer patients. The objective of the current meta-analysis was to determine its utility in predicting clinical and survival outcomes for cancer patients.
UNASSIGNED: Searching and screening literature from PubMed, Web of Science and Embase until September 13, 2022 was performed by two researchers independently. According to the exclusion and inclusion criteria, articles reporting the impact of malnutrition diagnosed by GLIM on long-term survival and clinical outcomes were included. Data of interest were also extracted from the included papers. The stability of the pooled results was evaluated using sensitivity analysis. With the aid of subgroup analysis, heterogeneity was revealed. To assess publication bias, Egger\'s and Begg\'s tests were conducted. The influence of publication bias on the pooling risk estimate was examined using a trim-and-fill analysis.
UNASSIGNED: 15 studies that qualified for our study were identified. Pooled hazard ratio (HR) from both multivariate and univariate regression analysis showed a worse overall survival in GLIM-defined malnourished cancer patients than those in well-nourished status. Meanwhile, disease-free survival was also poorer in malnourished patients. Moreover, pooled odds ratio (OR) demonstrated that malnourished cancer patients were more likely to develop overall postoperative complications, complications ≥ Clavien-Dindo grade IIa and complications ≥ Clavien-Dindo grade IIIa. Two articles reported negative relation between GLIM-defined malnutrition and 30-day readmission/mortality.
UNASSIGNED: GLIM-defined malnutrition possesses value in predicting poorer survival and clinical outcomes for cancer patients.
UNASSIGNED: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=321094], identifier [CRD42022321094].

The Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. This tool used the phenotypic and etiologic criteria to diagnose the malnutrition in adults. This meta-analysis aimed to examine the association between malnutrition defined by the GLIM and survival outcomes in patients with cancer.
Two independent authors comprehensively searched the articles indexed in PubMed, Web of Science, Embase databases until June 25, 2022. Only cohort studies evaluating the association of malnutrition defined by the GLIM with survival outcomes in cancer patients were included. The fully adjusted hazard ratio (HR) with 95% confidence intervals (CI) was pooled for the malnutrition versus the those without.
Twelve article reporting on 11 studies including 6799 cancer patients were identified. Four articles were grouped to have moderate risk of bias and 8 articles were deemed to have a low risk of bias. The prevalence of malnutrition defined by the GLIM ranged from 11.9% to 87.9%. Meta-analysis indicated that malnutrition defined by the GLIM was associated with poor overall survival (HR 1.90; 95% CI 1.58-2.29) and disease-free survival (HR 1.51; 95% CI 1.27-1.79), respectively. Subgroup analysis showed that the pooled HR was 1.49 (95% CI 1.32-1.68) for moderate malnutrition and 1.68 (95% CI 1.42-1.99) for severe malnutrition.
Malnutrition defined by the GLIM is significantly associated with reduced overall survival and disease-free survival in patients with cancer. Detection of nutritional status using GLIM has potential to improve survival stratification in these patients.