PP377 - INCLUSION OF THE NEUTROPHIL-TO-LYMPHOCYTE RATIO MAY IMPROVE GLIM-BASED RISK STRATIFICATION IN HOSPITALIZED MEDICAL PATIENTS: DATA FROM THE SIMI-NUTRO COHORT

PP377

INCLUSION OF THE NEUTROPHIL-TO-LYMPHOCYTE RATIO MAY IMPROVE GLIM-BASED RISK STRATIFICATION IN HOSPITALIZED MEDICAL PATIENTS: DATA FROM THE SIMI-NUTRO COHORT

C. Gallicchio^1,*, G. Imbimbo¹, M. I. Amabile², A. Molfino³, M. Muscaritoli¹ on behalf of SIMI-NUTRO Investigators

¹Department of Translational and Precision Medicine, ²Department of Surgical Sciences, ³Department of Interdisciplinary Studies on WellBeing, Health and Environmental Sustainability (BeSSA), Sapienza University of Rome, Rome, Italy

Rationale: Disease-related malnutrition with inflammation is characterized by inflammatory activation, contributing to catabolism and impaired anabolism. In this light, we aimed to evaluate whether systemic inflammation, assessed by the neutrophil-to-lymphocyte ratio (NLR) may improve Global Leadership Initiative on Malnutrition (GLIM)-based risk stratification in predicting infectious complications and length of stay (LOS) in hospitalized medical patients.

Methods: This is a subanalysis of the SIMI-NUTRO, a multicenter observational study conducted in 16 Internal Medicine wards in Italy, which showed that malnutrition was associated with significantly (p=0.001) longer hospital stay and higher rate of infectious complications. In the present sub-analysis, malnutrition was defined according to GLIM, not including inflammation. Patients were categorized as GLIM-negative (Group 0), GLIM-positive with NLR <3 (Group 1), and GLIM-positive with NLR ≥3 (Group 2).

Results: Among 506 patients (mean age 68.7 ± 16.3 years), GLIM-defined malnutrition was associated with higher inflammatory markers, including NLR (p=0.021) and CRP (p=0.002). NLR inversely correlated with anorexia VAS (r=−0.141, p=0.002), FAACT (r=−0.171, p = 0.001) and MNA-SF (r=-0.167 p=0.001). Group 0, Group 1, and Group 2 included 325 (64.2%), 65 (12.8%), and 116 (22.9%) patients, respectively. At multivariate analysis,Group 2 was independently associated with infectious complications (OR 4.28, 95% CI 2.18–8.38) and prolonged LOS (OR 1.98, 95% CI 1.19–3.28).

Conclusion: In hospitalized Internal Medicine patients, the combination of GLIM-defined malnutrition and elevated NLR identifies a subgroup at high-risk of infectious complications and prolonged hospitalization. Incorporating NLR may improve GLIM-based risk stratification, representing a new, simple, low-cost, and widely available tool. 

Disclosure of Interest: None declared