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Comparison of CIPA Nutritional Screening with GLIM Criteria for Malnutrition, Prognostic Evolution, and Association
Elena Márquez Mesa1, Adán Jesús Guerra Cabrera2, Ignacio Llorente Gómez de Segura1
1Endocrinology and Nutrition Department, Hospital Universitario Nuestra Señora de Candelaria, Ctra. Del Rosario 145, 38010 Santa Cruz de Tenerife, Spain.
Background:
Hospital malnutrition has high prevalence and is associated with worse clinical outcomes. The lack of standardized nutritional screening prompted the creation of the CIPA screening tool. Several studies have shown that the phase angle (PA) is associated with increased nutritional risk and worse clinical outcomes. The aim of this study was to establish the concordance between the CIPA and GLIM criteria and to assess their correlation with PA values and clinical outcomes.
Methods:
A cross-sectional single-center study was carried out, with a prospective six-month follow-up for the prognostic variables. On admission, the CIPA and GLIM criteria and bioimpedanciometry were assessed.
Results:
A total of 510 inpatients were included; 36.5% had positive CIPA outcomes and 46.1% had positive GLIM outcomes. The correlation between the CIPA and GLIM criteria had a kappa index of 0.26, p < 0.01. Those with positive CIPA had a higher mortality risk (OR = 1.81) and longer mean length of stay (MLS) (OR = 1.45). The PA cut-off points were determined by sex and age for CIPA (men > 65 years: 4.75°, men ≤ 65 years: 5.75°, women > 65 years: 4.75°, and women ≤ 65 years: 5.45°) and GLIM (men > 65 years: 4.95°, men ≤ 65 years: 5.85°, women > 65 years: 4.75°, and women ≤ 65 years: 5.55°). These PA cut-off points were associated with worse clinical outcomes with CIPA (mortality OR = 4.2; MLS OR = 1.51; readmissions OR = 2.28) and GLIM (mortality OR = 2.97; MLS OR = 2.61; readmissions OR = 1.79).
Conclusions:
CIPA screening shows a low correlation with GLIM nutritional assessment. Positive CIPA and GLIM have lower PAs than negative and worse prognostic outcomes. The PA cut-off points associated with worse outcomes have been established.
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