Association between GLIM diagnosed malnutrition and 18-month mortality in hospitalized adults with congestive heart
Ruoshu Duan1,2, Suxiu Chen1, Suxia Li1
1Department of General Practice, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China.
Insights
The Global Leadership Initiative on Malnutrition (GLIM) criteria effectively predict mortality in hospitalized congestive heart failure (CHF) patients. Malnutrition, identified by GLIM criteria, significantly increases mortality risk in this population.
Area of Science:
- Clinical Nutrition
- Cardiology
- Geriatrics
Background:
- Limited prospective validation of Global Leadership Initiative on Malnutrition (GLIM) criteria exists for hospitalized congestive heart failure (CHF) patients.
- This study addresses the prognostic performance of GLIM criteria versus Mini-Nutritional Assessment (MNA) in CHF inpatients.
Purpose of the Study:
- To compare the prognostic accuracy of GLIM criteria and MNA for all-cause mortality in CHF inpatients.
- To identify the strongest GLIM criterion predictor of mortality in this cohort.
Main Methods:
- A single-center prospective cohort study of 498 CHF inpatients.
- Agreement between GLIM and MNA assessed using Cohen κ coefficient.
- Survival analysis employed Kaplan-Meier curves and Cox regression.
Main Results:
- Malnutrition prevalence was high (47.2% GLIM, 50.4% MNA) with good agreement (κ=0.68).
- Malnutrition independently predicted higher all-cause mortality (GLIM HR 2.16, MNA HR 4.28).
- Low body mass index emerged as the strongest mortality predictor (HR 5.14).
Conclusions:
- GLIM criteria demonstrate strong consistency with MNA in CHF patients.
- GLIM criteria effectively predict 18-month all-cause mortality in hospitalized CHF patients.
Background:
The Global Leadership Initiative on Malnutrition (GLIM) criteria have been validated in various clinical settings since 2018, but prospective validation in patients with congestive heart failure (CHF) who are hospitalized remains limited. This study compares the prognostic performance of the GLIM criteria and Mini-Nutritional Assessment (MNA)-defined malnutrition for all-cause mortality in CHF patients and explores the strongest predictive indicator within the GLIM criteria.
Methods:
This single-center prospective cohort study included inpatients with CHF. Agreement between the GLIM criteria and MNA was assessed using Cohen κ coefficient. Survival data were analyzed using Kaplan-Meier curves and adjusted Cox regression analyses.
Results:
Among 498 CHF inpatients, 84 (16.9%) died during the 18-month follow-up. Malnutrition prevalence was 47.2% and 50.4% based on the GLIM criteria and MNA, respectively (κ = 0.68; P < 0.001). Malnutrition was independently associated with a higher risk of all-cause mortality (GLIM criteria: hazard ratio, 2.16 [95% confidence interval (CI), 1.13-4.13]; MNA: hazard ratio, 4.28 [95% CI, 1.98-9.22]). Low body mass index was the strongest predictor of all-cause mortality in multivariable analysis (hazard ratio, 5.14; 95% CI, 3.19-8.27).
Conclusion:
The GLIM criteria showed strong consistency with MNA and effectively predicted all-cause mortality in CHF patients within 18 months.
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