Validation of GLIM criteria and nutrition assessment tools in patients with mild and moderately severe acute...

The international guidelines recommend nutrition evaluation in all patients with mild and moderately severe acute pancreatitis (AP). The Global Leadership Initiative on Malnutrition (GLIM) criteria were developed for evaluating malnutrition. However, no prospective study has validated GLIM criteria in AP, and research on nutrition assessment tools in AP remains limited. This study aimed to validate GLIM criteria and evaluate nutrition assessment tools in patients with mild and moderately severe AP.

This prospective study enrolled patients diagnosed with mild and moderately severe AP from July 2022 to April 2023. GLIM criteria and subjective global assessment (SGA) were assessed by different trained clinicians. SGA was used as a semi-gold standard for diagnosis of malnutrition according to GLIM validation guidance. Clinical outcomes, including mortality, complications, length of stay (LOS), and 90-day readmission, were evaluated.

Sixty-five patients were enrolled. Mild and moderately severe AP were observed in 90.8% and 9.2% of patients, respectively. The prevalence of malnutrition, as assessed by GLIM criteria and SGA, was 21.5%. GLIM criteria showed a significant strong agreement (weighted κ = 0.817, 95% CI 0.57-1.00, p < 0.001) and strong diagnostic performance, with a sensitivity of 85.7%, specificity of 96.1%, positive predictive value of 85.7%, and negative predictive value of 96.1%. Only SGA was independently associated with LOS≥6 days (OR 4.67; 95% CI: 1.22-17.89, p = 0.025).

GLIM criteria demonstrated strong validity in diagnosing malnutrition in mild and moderately severe AP. Only SGA was independently associated with longer LOS. Further multicenter studies with larger populations are warranted to confirm these findings.