Global Leadership Initiative on Malnutrition (GLIM) versus Subjective Global Assessment in Detecting Malnutrition and Predicting Outcomes in Critically Ill Patients
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 200
- 试验地点
- 1
- 主要终点
- To assess the diagnostic performance of GLIM criteria (alone and in combination with NRS-2002 and mNUTRIC) for identifying malnutrition in critically ill ICU patients, using Subjective Global Assessment (SGA) as the reference standard.
研究概览
简要总结
Malnutrition is highly prevalent among critically ill patients admitted to intensive care units (ICUs) and is strongly associated with poor clinical outcomes including prolonged ICU stay, increased duration of mechanical ventilation, higher risk of infections, and increased mortality. Accurately diagnosing malnutrition early in these patients is essential to initiate timely nutritional interventions and improve clinical outcomes. Traditionally, the Subjective Global Assessment (SGA) has been the reference standard tool for diagnosing malnutrition in hospitalized patients. However, the SGA has limitations in ICU settings, where patients are often sedated, mechanically ventilated, or unable to provide their clinical history, reducing its applicability and accuracy.
The Global Leadership Initiative on Malnutrition (GLIM) criteria, developed in 2018, offer a new consensus framework for diagnosing malnutrition through a two-step process: first identification of nutritional risk, followed by diagnosis using phenotypic criteria (such as weight loss, low BMI, or reduced muscle mass) combined with etiologic criteria (such as reduced food intake or inflammation). Recent research suggests that combining GLIM criteria with validated nutritional risk screening tools like Nutritional Risk Screening 2002 (NRS-2002) and modified Nutrition Risk in Critically Ill (mNUTRIC) score enhances the detection and prognostic accuracy of malnutrition in ICU patients.
This prospective observational study conducted in the Indian ICU setting aims to compare the diagnostic accuracy and predictive validity of GLIM alone, GLIM combined with NRS-2002, and GLIM combined with mNUTRIC against SGA. The study will also evaluate the prevalence of malnutrition detected by these tools and their ability to predict important ICU outcomes, including length of stay, duration of mechanical ventilation, vasopressor use, and mortality. The findings will provide critical data to validate and optimize malnutrition assessment protocols in critically ill Indian patients and support better clinical decision-making toward personalized nutritional support in critical care.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •Age more than 18 years.
- •ICU stay is anticipated to be more than 48 hours.
- •Availability of complete clinical data (e.g., APACHE II and SOFA scores), anthropometric measurements (height, weight, BMI), and laboratory parameters (such as CRP) required to apply GLIM, SGA, NRS-2002, and mNUTRIC criteria.
排除标准
- •Pregnant or lactating women.
- •ICU readmission during the same hospital stay.
- •Incomplete or missing data that preclude the application of nutritional assessment tools.
结局指标
主要结局
To assess the diagnostic performance of GLIM criteria (alone and in combination with NRS-2002 and mNUTRIC) for identifying malnutrition in critically ill ICU patients, using Subjective Global Assessment (SGA) as the reference standard.
时间窗: 28 days
次要结局
- 1. To assess the prevalence of malnutrition identified by GLIM, GLIM + NRS-2002, and GLIM + mNUTRIC.(2. To evaluate the agreement between each diagnostic method (GLIM, GLIM + NRS-2002, and GLIM + mNUTRIC) and the Subjective Global Assessment (SGA), used as the reference standard.)
研究者
Manoj Kumar R
Father Muller Medical College