标准化和简化全球营养不良领导倡议 (GLIM),以便更广泛地应用
G Kurik1, C Kelly-Bissue1, A Lõhmus1
1Institute of Clinical Medicine, University of Tartu, Puusepa 8, 50406, Tartu, Estonia.
Clinical nutrition ESPEN
|June 20, 2024
概括
全球营养不良领导倡议 (GLIM) 标准可以作为营养不良的综合查和评估工具. 中上臂周长 (MUAC) 是一种简单,易于使用的肌肉评估方法,可以改善早期检测.
科学领域:
- 临床营养学 临床营养学
- 医学诊断 医学诊断 医学诊断
- 患者评估 患者评估
背景情况:
- 营养不良影响到20-50%的医院病人,往往没有立即识别.
- 全球营养不良领导倡议 (GLIM) 的标准旨在标准化营养不良的诊断.
- 实施的挑战包括依赖先前选工具和一致的肌肉质量评估.
研究的目的:
- 评估GLIM标准的不同查和肌肉评估方法.
- 为更广泛的GLIM应用提出更简单的方法.
- 优化医院营养不良查的效率和准确性.
主要方法:
- 在300名患者中,与NRS-2002,MUST或没有查对主观全球评估 (SGA) 的GLIM评分进行比较.
- 关于肌肉评估的中上臂周长 (MUAC) 和小腿周长 (CC) 的文献审查.
- 用不同的查策略测量GLIM评分所需的时间.
主要成果:
- 与SGA相比,没有先前查的GLIM显示出最高的灵敏度 (65%) 和NPV (76%).
- 中上臂周长 (MUAC) 受到和性别的影响小于小腿周长 (CC).
- 没有先前查或先前MUST "1"的GLIM具有最高的ROC AUC (0.78);随着NRS-2002查的时间增加.
结论:
- 预先查可以降低GLIM灵敏度并增加时间;金标准肌肉评估并不普遍可用.
- 建议使用GLIM作为综合查和评估工具.
- 支持MUAC作为全球可访问的肌肉评估方法,以简化GLIM的使用并改善早期营养不良的检测.
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