LB057 - CLINICAL OUTCOMES ACCORDING TO GLIM-DEFINED MALNUTRITION SEVERITY IN EMERGENCY GASTROINTESTINAL SURGERY

LB057

CLINICAL OUTCOMES ACCORDING TO GLIM-DEFINED MALNUTRITION SEVERITY IN EMERGENCY GASTROINTESTINAL SURGERY

N. Fukushima^1,*, K. Tsuboi¹, F. Yano¹, K. Eto¹

¹Surgery, The Jikei University School of Medicine, Tokyo, Japan

Rationale: Malnutrition is common among patients requiring emergency gastrointestinal (GI) surgery and may adversely affect postoperative recovery and survival. However, the clinical　significance of malnutrition severity defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria in emergency surgical settings remains insufficiently investigated.

Methods: A retrospective analysis was conducted in 505 patients who underwent emergency GI surgery between 2013 and 2025. Nutritional status was assessed according to the GLIM framework using body weight loss, body mass index, and computed tomography–derived skeletal muscle mass. Patients were categorized as non-malnourished, moderately malnourished, or severely malnourished. Postoperative morbidity, in-hospital mortality, and overall survival (OS) were evaluated. Independent predictors were analyzed using multivariable logistic and Cox regression models.

Results: Among the cohort, 41.8% met the GLIM criteria for malnutrition, including 26.3% classified as severe. Severe malnutrition was significantly associated with postoperative morbidity and in-hospital mortality in multivariable analyses (morbidity: odds ratio [OR] 2.13, p<0.01; mortality: OR 2.87, p<0.01). In survival analyses, both moderate and severe malnutrition were independently associated with worse OS (moderate: hazard ratio [HR] 2.43, p<0.01; severe: HR 2.84, p<0.01). One-year OS progressively decreased according to nutritional severity (non-malnourished: 90.8%; moderate: 74.5%; severe: 65.6%).

Conclusion: GLIM-defined malnutrition severity was independently associated with adverse short- and long-term outcomes after emergency GI surgery. GLIM-based nutritional assessment may facilitate perioperative risk stratification in emergency surgical patients.

Disclosure of Interest: None declared