GLIM‑Defined Malnutrition in Critically Ill Patients: A Comparison of Nutrition Risk Screening 2002 and Modified...

Area of Science:

• Clinical Nutrition
• Critical Care Medicine
• Nutritional Assessment

Background:

• Malnutrition is prevalent and prognostically significant in critically ill patients.
• Accurate nutritional screening is crucial for timely intervention in intensive care units (ICUs).
• The Global Leadership Initiative on Malnutrition (GLIM) framework provides criteria for diagnosing malnutrition.

Purpose of the Study:

• To compare the consistency of Nutrition Risk Screening-2002 (NRS-2002) and the modified Nutrition Risk in the Critically Ill (mNUTRIC) as initial screening tools within the GLIM framework.
• To assess the association of NRS-2002 and mNUTRIC with clinical outcomes in critically ill patients.
• To explore the impact of nutritional treatment on outcomes in patients identified with malnutrition.

Main Methods:

• A prospective observational study involving 173 critically ill patients admitted to an ICU for at least 4 days.
• Nutritional risk screening was performed within 24 hours of admission using NRS-2002 and mNUTRIC.
• GLIM criteria were used for malnutrition diagnosis in patients screening positive; consistency and outcome associations were analyzed.

Main Results:

• Malnutrition prevalence was 18.5% (NRS-2002+GLIM) and 13.9% (mNUTRIC+GLIM), with substantial agreement between the tools (κ = 0.79).
• Malnutrition diagnosed via mNUTRIC+GLIM showed stronger associations with increased ICU sedation days, vasopressor use, and adverse discharge status.
• An exploratory subgroup analysis indicated lower in-hospital mortality in patients treated for malnutrition identified by mNUTRIC+GLIM.

Conclusions:

• Both NRS-2002+GLIM and mNUTRIC+GLIM demonstrate consistency and association with unfavorable outcomes in critically ill patients.
• The mNUTRIC+GLIM strategy exhibits superior prognostic value compared to NRS-2002+GLIM.
• mNUTRIC+GLIM is a potentially more appropriate screening strategy for identifying malnutrition and predicting outcomes in critically ill populations.