Supplementary Material for: The Combined Usage of the Global Leadership Initiative on Malnutrition Criteria and Controlling Nutrition Status Score in Acute Care Hospitals

Introduction: The Global Leadership Initiative on Malnutrition (GLIM) lacks reliable blood tests for evaluating the nutrition status. We retrospectively compared the GLIM criteria, Controlling Nutrition Status (CONUT) score, and Subjective Global Assessment (SGA) to establish effective malnutrition screening and provide appropriate nutritional interventions according to severity. Methods: We classified 177 patients into 3 malnutrition categories (normal/mild, moderate, and severe) according to the GLIM criteria, CONUT score, and SGA. We investigated the malnutrition prevalence, concordance of malnutrition severity, predictability of clinical outcome, concordance by etiology, and clinical outcome by inflammation. Results: The highest prevalence of malnutrition was found using the GLIM criteria (87.6%). Concordance of malnutrition severity was low between the GLIM criteria and CONUT score. Concordance by etiology was low in all groups but was the highest in the “acute disease” group. The area under the curve of clinical outcome and that of the “with inflammation group” were significantly higher when using the CONUT score versus using the other tools (0.679 and 0.683, respectively). Conclusion: The GLIM criteria have high sensitivity, while the CONUT score can effectively predict the clinical outcome of malnutrition. Their combined use can efficiently screen for malnutrition and patient severity in acute care hospitals.

引言：营养不良全球领导倡议（Global Leadership Initiative on Malnutrition, GLIM）目前尚未拥有用于评估营养状况的可靠血液检测手段。本研究采用回顾性研究设计，对比分析了GLIM标准、营养状况控制评分（Controlling Nutrition Status, CONUT）与主观全面评定（Subjective Global Assessment, SGA）三种工具，旨在建立高效的营养不良筛查方案，并可依据营养不良严重程度为患者提供适配的营养干预措施。方法：本研究依据GLIM标准、CONUT评分及SGA工具，将177例患者划分为3个营养不良层级（营养正常/轻度营养不良、中度营养不良、重度营养不良）。本研究考察了以下核心指标：营养不良患病率、营养不良严重程度评估一致性、临床结局预测效能、不同病因下的评估一致性，以及不同炎症状态下的临床结局差异。结果：采用GLIM标准评估时，营养不良的检出率最高，达87.6%。GLIM标准与CONUT评分在营养不良严重程度的评估一致性较低。所有病因亚组的评估一致性均偏低，但在急性疾病亚组中一致性最高。相较于其他评估工具，采用CONUT评分时，临床结局的受试者工作特征曲线下面积以及伴炎症亚组的受试者工作特征曲线下面积均显著更高，分别为0.679和0.683。结论：GLIM标准具有较高的筛查灵敏度，而CONUT评分可有效预测营养不良患者的临床结局。二者联合应用可在急性护理医院中高效完成营养不良筛查与患者严重程度分层。