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Type:	Artigo de Periódico
Title:	Different combinations of the GLIM criteria for patients awaiting a liver transplant: poor performance for malnutrition diagnosis but a potentially useful prognostic tool
Authors:	Bárbara Chaves Santos Ana Luisa Ferreira Fonseca Lívia Garcia Ferreira Helem Sena Ribeiro Maria Isabel Toulson Davisson Correia Agnaldo Soares Lima Francisco Guilherme Cancela e Penna Lucilene Rezende Anastácio
Abstract:	Background & aims Studies using the Global Leadership Initiative on Malnutrition (GLIM) criteria for patients with liver cirrhosis are limited. This study aimed to assess the impact of malnutrition according to the GLIM criteria on the outcomes of patients awaiting a liver transplant (LTx) and compare these criteria with Subjective Global Assessment (SGA). Methods This retrospective observational study included adult patients awaiting LTx. Patient clinical data, nutritional status according to various tools including SGA, and resting energy expenditure were assessed. The distinct phenotypic and etiologic criteria provided 36 different GLIM combinations. The GLIM criteria and SGA were compared using the kappa coefficient. The variables associated with mortality before and after the LTx and with a longer length of stay (LOS) after LTx (≥18 days) were assessed by Cox regression and logistic regression analyses, respectively. Results A total of 152 patients were included [median age 52.0 (interquartile range: 46.5–59.5) years; 66.4% men; 63.2% malnourished according to SGA]. The prevalence of malnutrition according to the GLIM criteria ranged from 0.7% to 30.9%. The majority of the GLIM combinations exhibited poor agreement with SGA. Independent predictors of mortality before and after LTx were presence of ascites or edema (p = 0.011; HR:2.58; CI95%:1.24–5.36), GLIM 32 (PA-phase angle + MELD) (p = 0.026; HR:2.08; CI95%:1.09–3.97), GLIM 33 (PA + MELD-Na ≥ 12) (p = 0.018; HR:2.17; CI95%:1.14–4.13), and GLIM 34 (PA + Child–Pugh) (p = 0.043; HR:1.96; CI95%:1.02–3.77). Malnutrition according to GLIM 28 (handgrip strength + Child-Pugh) was independently associated with a longer LOS (p = 0.029; OR:7.21; CI95%:1.22–42.50). Conclusion The majority of GLIM combinations had poor agreement with SGA, and 4 of the 36 GLIM combinations were independently associated with adverse outcomes.
Subject:	Pacientes Transplante Fígado Desnutrição
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	FAR - DEPARTAMENTO DE ALIMENTOS MED - DEPARTAMENTO DE CIRURGIA
Rights:	Acesso Restrito
metadata.dc.identifier.doi:	https://doi.org/10.1016/j.clnu.2021.11.008
URI:	http://hdl.handle.net/1843/79476
Issue Date:	Jan-2022
metadata.dc.url.externa:	https://www.sciencedirect.com/science/article/abs/pii/S0261561421005094
metadata.dc.relation.ispartof:	Clinical Nutrition
Appears in Collections:	Artigo de Periódico

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