P439 - MALNUTRITION IN CRITICAL ILLNESS: GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION (GLIM) VERSUS PATIENT-GENERATED SUBJECTIVE GLOBAL ASSESSMENT (PG-SGA)

P439

MALNUTRITION IN CRITICAL ILLNESS: GLOBAL LEADERSHIP INITIATIVE ON MALNUTRITION (GLIM) VERSUS PATIENT-GENERATED SUBJECTIVE GLOBAL ASSESSMENT (PG-SGA)

S. Chand^1,*, I. Price¹, R. Watkin-Brown², V. Asrani², A. Braakhuis¹

¹Nutrition & Dietetics, University of Auckland, ²Nutrition & Dietetics, Auckland City Hospital, Auckland, New Zealand

Rationale: Malnutrition is prevalent in intensive care units (ICUs) and has adverse effects on clinical outcomes. Despite this, malnutrition is frequently unrecognised. There is no universally accepted malnutrition assessment tool utilised in the critically ill patient. This study aimed to compare malnutrition using the GLIM and the PG-SGA.

Methods: A cross-sectional study was conducted in 48 ICU patients. Phenotypic criteria was used to assess GLIM: unintentional weight loss (GLIM weight loss), body mass index (BMI) (GLIM BMI), calf circumference (CC) (GLIM CC), ultrasound (US) (GLIM US), and mid-upper arm circumference (MUAC) (GLIM MUAC). Fisher’s exact test was used to compare malnutrition assessment tools.

Results: A statistically significant difference was observed between malnutrition assessed by any GLIM phenotypic criteria (p <0.0001), GLIM CC (p = 0.02), GLIM US (p <0.0001), and GLIM MUAC versus the PG-SGA. GLIM assessed by any phenotypic criteria had a sensitivity of 86%, specificity of 81%, and kappa of 0.62 (95% confidence interval 0.289-0.950). GLIM demonstrated criterion validity, but reliability was not achieved. A statistically significant difference was observed in the assessment of malnutrition based on the phenotypic criteria used: GLIM weight loss versus GLIM BMI (p = 0.03), versus GLIM US (p = 0.0001), versus GLIM MUAC (p = 0.005), GLIM BMI versus GLIM CC (p <0.0001), versus GLIM US (p <0.0001), GLIM CC versus GLIM US (p = 0.04), versus GLIM MUAC (p <0.0001), and GLIM US versus GLIM MUAC (p <0.0001).

Conclusion: This study provided valuable insights into the use of GLIM for malnutrition assessment compared to the PG-SGA in the critically ill. While GLIM demonstrated criterion validity compared to the PG-SGA, further research is needed on the reliability of GLIM in the ICU setting.

Disclosure of Interest: None declared