GLIM-defined malnutrition in patients with acute abdomen associated with poor prognosis and increased economic burden: A cross-sectional study

Nutr Clin Pract. 2024 Dec;39(6):1364-1374. doi: 10.1002/ncp.11202. Epub 2024 Aug 27.

Abstract

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria have rapidly developed into a principal methodological framework for nutrition diagnosis. However, the applicability of the GLIM criteria in patients with acute abdomen has not been validated.

Methods: This is a cross-sectional study conducted on patients diagnosed with acute abdomen and admitted to a tertiary hospital in southwest China. Nutrition risk screening was conducted using the Nutrition Risk Screening 2002, and patients identified with nutrition risk were assessed for malnutrition based on the GLIM criteria.

Results: We enrolled a total of 440 patients with acute abdomen. The top three diagnoses of acute abdomen were intestinal obstruction (47.2%), acute appendicitis (23.1%), and digestive system perforation (8.8%). The prevalence of nutrition risk was 46.5%, with a malnutrition rate of 32.5% based on the GLIM. Patients with malnutrition according to the GLIM showed significantly higher rates of intensive care unit (ICU) admission (13.28% vs 7.07%; P = 0.003), increased hospitalization costs (median: 3315USD [interquartile range (IQR): 978-7852] vs 1641 [IQR: 816-3523] USD; P < 0.001), and longer length of hospital stay (LOS) (median: 8 [IQR: 5-13] vs 6 [IQR: 4-8] days; P < 0.001) compared with patients without malnutrition. Multivariate analysis indicated that GLIM-defined malnutrition was an independent predictor of hospitalization costs, and severe malnutrition was an independent predictor of ICU admission.

Conclusion: GLIM criteria are applicable for diagnosing malnutrition in patients with acute abdomen. The prevalence of malnutrition was high in patients with acute abdomen. Malnutrition was associated with increased ICU admission and LOS, along with higher economic burden.

Keywords: GLIM; acute abdomen; emergency department; malnutrition; nutritional risk.

MeSH terms

  • Abdomen, Acute* / epidemiology
  • Abdomen, Acute* / etiology
  • Adult
  • Aged
  • China / epidemiology
  • Cost of Illness
  • Cross-Sectional Studies
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Intestinal Obstruction / economics
  • Intestinal Obstruction / epidemiology
  • Intestinal Obstruction / etiology
  • Length of Stay / statistics & numerical data
  • Male
  • Malnutrition* / diagnosis
  • Malnutrition* / economics
  • Malnutrition* / epidemiology
  • Middle Aged
  • Nutrition Assessment*
  • Nutritional Status
  • Prevalence
  • Prognosis