Affiliation:
1. Graduate Program in Medical Sciences, Endocrinology Universidade Federal do Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil
2. Hospital de Clínicas de Porto Alegre Porto Alegre R Rio Grande do Sul Brazil
3. Graduate Program in Food, Nutrition, and Health Universidade Federal do Rio Grande do Sul Porto Alegre R Rio Grande do Sul Brazil
Abstract
AbstractBackgroundMalnutrition is a prevalent condition among older patients and is associated with worse clinical outcomes. Methods such as the Subjective Global Assessment (SGA), the Mini Nutritional Assessment Long Form (MNA‐LF), and the Global Leadership Initiative on Malnutrition (GLIM) diagnose malnutrition early. This study aimed to evaluate the performance and validity of these instruments to predict the length of hospital stay (LOS) and in‐hospital mortality in older surgical patients.MethodsThis prospective cohort study was performed in hospitalized older surgical patients. In the first 48 h of admission, general data were collected, and patients were evaluated by SGA, MNA‐LF, and GLIM using calf circumference (CC) and mid‐upper arm circumference (MUAC) as phenotypic criteria for nutrition diagnoses. Accuracy tests and regression analysis adjusted for sex, type of surgery, and the Charlson Comorbidity Index adjusted for age were performed to assess the criterion validity of instruments to predict LOS and mortality.ResultsA total of 214 patients (age 75.4 ± 6.6 years, 57.3% men, and 71.1% admitted to elective surgery) were evaluated. Malnutrition was diagnosed in 39.7% (SGA), 63% (MNA‐LF), 41.6% (GLIMCC), and 32.1% (GLIMMUAC) of patients. GLIMCC had the best accuracy (AUC = 0.70; 95% CI, 0.63–0.79) and sensitivity (95.8%) to predict in‐hospital mortality. In the adjusted analysis, malnutrition, according to SGA, MNA‐LF, and GLIMCC, increased the risk of in‐hospital mortality by 3.12 (95% CI, 1.08–11.34), 4.51 (95% CI, 1.29–17.61), and 4.83 (95% CI, 1.52–15.22), respectively.ConclusionGLIMCC had the best performance and satisfactory criterion validity to predict in‐hospital mortality in older surgical patients.
Funder
National Science Foundation
Subject
Nutrition and Dietetics,Medicine (miscellaneous)