Impact of malnutrition diagnosed using GLIM criteria on clinical outcomes of patients with gastric cancer.

OBJECTIVE To validate the effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria in malnutrition diagnosis compared with Patient-Generated Subjective Global Assessment (PG-SGA) and assess the impact of malnutrition diagnosed using GLIM criteria on the clinical outcomes of patients with GC. METHODS We retrospectively analyzed the data of 895 patients who underwent radical gastrectomy at the First Affiliated Hospital of Wenzhou Medical University. Nutrition assessment was performed on all patients according to the GLIM criteria and PG-SGA. Kappa statistic was used to evaluate the agreement between two methods. Multivariate logistic regression and Cox regression based on single factor analysis were used to predict postoperative complications and overall survival rates. RESULTS Based on the GLIM criteria, 38.3% of the patients were diagnosed as malnourished, including 21.7% Stage I (moderate malnutrition) and 16.6% Stage II (severe malnutrition). GLIM criteria had a moderate agreement with PG-SGA (K = 0.548). Patients in the Stage II malnutrition group had a higher incidence of complications, a longer postoperative length of stay, and higher hospitalization costs. Logistic regression showed that Stage II malnutrition was an independent risk predictor of postoperative complications (OR: 3.28; 95% CI: 2.18-4.94). Furthermore, Cox regression analysis showed that both Stage I (HR: 1.52; 95% CI: 1.11-2.07; P = 0.009) and Stage II (HR: 1.85; 95% CI: 1.34-2.53; P<0.001) malnutrition were independent risk predictors of overall survival. CONCLUSION Diagnosis of malnutrition according to the GLIM criteria is useful in predicting the adverse postoperative clinical outcomes of patients with gastric cancer. This article is protected by copyright. All rights reserved.