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Cited by 55Clinical Nutrition and GastroenterologyNutrition and Health in AgingSepsis Diagnosis and Treatment

The global leadership initiative on malnutrition criteria for the diagnosis of malnutrition in patients admitted to the intensive care unit: A systematic review and meta-analysis

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Díaz, Gustavo, T.D. Correia, Maria Isabel, Gonzalez, Maria Cristina, Reyes, Mariana·2023·Clinical Nutrition
DOI 10.1016/j.clnu.2022.12.007
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Abstract

Background Malnutrition is associated with a high risk of morbidity and mortality in patients with critical illness. The nutrition status of patients in the intensive care unit (ICU) is challenging to assess. The Global Leadership Initiative on Malnutrition (GLIM) is a novel framework used for the diagnosis of malnutrition. However, its efficacy in patients with critical illness in the ICU has not been validated. Aim To investigate the use and validity of the GLIM criteria in adult patients admitted to the ICU. Methods A systematic review and meta-analysis were performed, and seven databases were searched for relevant studies. The selection criteria included studies that used the GLIM in adult patients admitted to the ICU. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Results Five studies were included in the analysis. Approximately 15%-68% of patients were diagnosed with malnutrition using the GLIM criteria. Meanwhile, 48%-75% of patients with malnutrition were identified with the Subjective Global Assessment (SGA). The inflammation criterion was easily adjudicated due to critical status, and three studies compared the GLIM and the SGA. According to the QUADAS-2 tool, the nutritional assessment process was not explicit in the studies. The meta-analysis had an overall sensitivity of 65.3% (95% CI: 34.9%-86.9%) and an overall specificity of 88.8% (95% CI: 58.1%-97.8%). In the prospective validation, malnutrition assessed by the GLIM criteria, and the SGA was associated with mortality. However, the association between length of hospital stay and mechanical ventilation was unclear. Conclusions The use and validity of the GLIM criteria among patients admitted to the ICU is still limited. Moreover, some concurrent and predictive validation studies have methodological limitations. Further studies must be performed to validate the use of the GLIM criteria in the ICU.

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  • A smaller meta-analysis of five intensive care unit studies concluded that the small sample of 337 patients and heterogeneity limited the resulting sensitivity to 65.5% (95% CI, 35%-86.8%); specificity was 86.9% (95% CI, 59.3%-96.9%).

    “A smaller meta‐analysis that included five intensive care unit studies concluded that the small sample of 337 patients and the heterogeneity limited the resulting sensitivity to 65.5% (95% CI, 35%–86.8%). Specificity was 86.9% (95% CI, 59.3%–96.9%). 13”

    From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [13]

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  • Two meta-analyses focus on criterion validity.

    “Two meta‐analyses focus on criterion validity. 12 , 13”

    From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [13]

  • The large number of individual validation studies provided the basis for 10 systematic reviews, some including meta-analyses, exploring different aspects and settings of GLIM published through March 5, 2024.

    “The large number of individual validation studies has provided the basis for 10 SRs, some including meta‐analyses, exploring different aspects and settings of GLIM (Table 1) published through March 5, 2024.”

    From GLIM consensus approach to diagnosis of malnutrition: A 5‐year update (2025) · cites this paper as [13]

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Authors
Díaz, G., T.D. Correia, M. I., Gonzalez, M. C., & Reyes, M.
Affiliations
Universidad El Bosque (CO)
Corresponding author
  • Díaz, Gustavo
  • Reyes, Mariana
ORCID
Venue
Clinical Nutrition
Publisher
Elsevier BV
Published
2023-02
Volume
42
Issue
2
Pages
182-189
ISSN
0261-5614 (ISSN-L)
DOI
10.1016/j.clnu.2022.12.007
OpenAlex
W4313531543
Cited by
55
References
36
Citations by year
2026: 13 · 2025: 23 · 2024: 15 · 2023: 3 · 2016: 1
FWCI
1.39
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Repositorio Institucional Universidad El Bosque (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
malnutrition, GLIM criteria, intensive care unit, critical illness, nutritional assessment, Subjective Global Assessment, diagnostic accuracy, sensitivity and specificity, mortality
MeSH terms
Adult, Hospitalization, Humans, Intensive Care Units, Leadership, Nutritional Status, Nutrition Assessment, Critical Illness, Malnutrition

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