PD298 - DIAGNOSTIC IMAGING AS A TOOL FOR MALNUTRITION ASSESSMENT IN THE ICU: A RETROSPECTIVE PILOT STUDY ON THE CLINICAL UTILITY OF CT SCANS AND GLIM CRITERIA

PD298

DIAGNOSTIC IMAGING AS A TOOL FOR MALNUTRITION ASSESSMENT IN THE ICU: A RETROSPECTIVE PILOT STUDY ON THE CLINICAL UTILITY OF CT SCANS AND GLIM CRITERIA

L. De Carli¹, D. Bonfanti^1,*, R. Scotto Busato¹, C. Bertino², M. Zanardi¹, A. Pezzana¹

¹Clinical Nutrition, ²Intensive Care Unit, ASL Città di Torino, Turin, Italy

Rationale: Malnutrition in the Intensive Care Unit (ICU) is frequently underdiagnosed despite its impact on outcomes. The Global Leadership Initiative on Malnutrition (GLIM) criteria recommend the presence of at least one phenotypic and one etiologic criterion for diagnosis. Among phenotypic criteria, low muscle mass is particularly relevant, but its assessment in critically ill patients is often limited by fluid overload and organizational constraints. Computed Tomography (CT) at the third lumbar vertebra (L3) is considered the gold standard for skeletal muscle quantification. This study evaluates whether routine CT scans can support GLIM-based malnutrition diagnosis in ICU patients.

Methods: All patients admitted to the ICU between January and March 2006 with a length of stay (LOS) ≥ 7 days were retrospectively analyzed. The frequency and type of CT scans performed during hospitalization or within 48 hours before admission were recorded.

Results: Twenty-five patients met inclusion criteria. Among them, 19 (76%) underwent at least one abdominal CT, 5 (20%) a chest CT, and 1 (4%) a head CT. Overall, 80% of scans were performed within 48 hours before ICU admission or during the first three days of stay.

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Conclusion: Most ICU patients with prolonged LOS undergo CT imaging for clinical reasons, particularly abdominal CT, which allows muscle mass assessment at L3. Although not performed for nutritional purposes, these scans provide useful data for GLIM-based diagnosis. Chest CT typically reaches L1; a slight caudal extension could increase diagnostic yield by up to 20%. Systematic inclusion of the Skeletal Muscle Index (SMI) in CT reporting could facilitate faster, more accurate malnutrition diagnosis. Furthermore, the early timing of these scans allows for a prompt assessment, minimizing the confounding effects of fluid overload on body composition analysis.

Disclosure of Interest: None declared