Abstract:

Objective

To evaluate the efficiency of the Global Leadership Initiative on Malnutrition （GLIM） consensus criteria for diagnosing malnutrition in elderly inpatients， and to identify the optimal combination of nutritional assessment tools for the "nutritional screening-assessmentdiagnosis" clinical pathway.

Methods

A cross-sectional study was performed to compare GLIM with the nutritional risk screening 2002 （NRS2002）， the mini-nutritional assessment short-form （MNA-SF），the geriatric nutritional risk index （GNRI）， and the subjective global assessment （SGA）. The reliability of GLIM was evaluated by the Kappa （κ）. Sensitivity， specificity， the positive predictive value， the negative predictive value and Youden's index （γ） were used to evaluate GLIM's validity.

Results

Using NRS-2002， MNA-SF， GNRI， SGA， and GLIM as the diagnostic criteria for malnutrition， the incidence rates of malnutrition were 75.64%， 47.12%， 55.45%， 74.68%， and 51.28%， respectively. Among these， GLIM showed a high level of agreement with MNA-SF and SGA （κ=0.824， 0.824； γ=0.79， 0.83）， while the agreement between GLIM and NRS2002 as well as GNRI was relatively weak （κ=0.480， 0.344； γ=0.48，0.34） .

Conclusion

The prevalence of malnutrition or the risk of malnutrition among hospitalized elderly patients is relatively high. It is recommended to use NRS2002 and GNRI for nutritional risk screening， followed by GLIM for nutritional assessment and malnutrition diagnosis.

Key words: Malnutrition, Elderly inpatient, Nutritional screening, Nutrition assessment, Global Leadership Initiative on Malnutrition