Predictive Ability of the GLIM Criteria on Long-term Prognosis in Patients Staying in a Palliative Care Unit: A Prospective Study

Abstract

Abstract Introduction: Prognostic criteria are important tools that guide the management of patients. It was aimed to evaluate the malnutrition status of the patients hospitalized in the palliative care center according to the GLIM criteria and to investigate its effect on the long-term prognosis.Materials and Methods GLIM criteria were used to evaluate the malnutrition status of the participants. In order to evaluate the prognosis, length of hospital stay(LOS), mortality, need for intensive care, mortality during hospitalization, and after discharge were considered. Comorbidities were scored according to the Modified Charlson Comorbidity Index. In addition, a questionnaire form was used to recognize the socio-demographic characteristics of the individuals.Results A total of 84 patients were included in the study [52.4% women, 56% married, and the median age 74 years(min 20, max 95)]. According to the GLIM criteria, 79.8% (n = 67) of the participants were diagnosed as malnutrition. The median LOS of the patients in the palliative care center was 15(min:1-max:135) days, and the median follow-up period after discharge was 284(min:182- max:350) days. Mortality rates of the patients with malnutrition were higher during the follow-up period compared to the patients without malnutrition. Advanced age and higher Modified Charlson comorbidity score were significantly associated with mortality. There was an inverse relationship between long hospital stay and mortality rate. There was no statistically significant relationship between gender, marital status, income and education status, and mortality. Malnutrition was more commonly diagnosed in patients with dementia, high comorbidity index, and advanced age. The regression analysis showed malnutrition, malignancy, age, COPD, and dementia were the independent predictors for mortality during the follow-up period.Conclusion Malnutrition might be an independent risk factor for mortality in inpatients in a palliative care center. Screening patients for malnutrition at regular intervals and providing early nutritional support may have positive results in terms of prognosis.