Comparison between GLIM and PG-SGA methods in the nutritional assessment of hospitalized oncological patients

Authors

Keywords:

Inflammation, Malnutrition, Nutritionalstatus, Weightloss

Abstract

Objective
The aim of this study was to compare the Global Leadership Initiative on Malnutrition and Subjective Global Assessment methods produced by the patient in the nutritional assessment of cancer in-patients.
Methods
Cross-sectional study with a prospective variable, conducted with patients admitted to a public hospital in Pernambuco, Brazil. The application of these tools and the diagnosis of malnutrition were performed within the first 48 hours of admission. Sociodemographic, clinical and laboratory data were obtained from the medical records and weight, height, arm circumference, triceps skinfold and handgrip strength data were collected.
Results
The 82 patients evaluated included mostly men aged ≥ 60 years with less than 8 years education. Malnutrition frequency was 93.7% according to the Subjective Global Assessment and including 23.2% severe malnutrition while, according to the Global Leadership Initiative on Malnutrition, 50% of the patients were considered severely malnourished. Malnutrition by the Global Leadership Initiative on Malnutrition showed a sensitivity of 82.9% and when associated with handgrip strength sensitivity was 90.8%, considering the Subjective global assessment produced by the patient as a reference; on the other hand, the specificity was 16.7% independently of adding handgrip strength. None of the anthropometric variables was associated with the reference tool.
Conclusion
The Global Leadership Initiative on Malnutrition proved to be a very sensitive tool for diagnosing malnutrition when compared to the gold standard, particularly for severe malnutrition, but with little specificity. The need for a comprehensive nutritional assessment in the clinical practice was confirmed, using the parameters available and not interpreting them separately.

References

Ministério da Saúde (Brasil). Glossário temático: controle de câncer. Brasília: Ministério; 2013.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: Instituto; 2019.

Campos SBG, Azevedo SCL, Gomes TRS, Bueno NB, Goulart MOF, Moura FA. Lack of concordance among nutritional diagnostic methods in newly diagnosed colorectal câncer patients. Nutr Cancer. 2021;9:1-8.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Consenso nacional de nutrição oncológica. Rio de Janeiro: Instituto; 2016.

Horie LM, Barrére APN, Castro MG, Liviera AMB, Carvalho AMB, Pereira A, et al. Diretrizes BRASPEN de terapia nutricional no paciente com câncer. BRASPEN J. 2019;34 Suppl 1:1-32.

Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH. Cancer-associated cachexia. Nat Rev Dis Primers. 2018;4:e17105. https://doi.org/10.1038/nrdp.2017.105

Gomes NS, Maio R. Avaliação subjetiva global produzida pelo próprio paciente e indicadores de risco nutricional no paciente oncológico em quimioterapia. Rev Bras Cancerol. 2015;61(3):235-24.

Gonzalez MC, Borges LR, Silveira DH, Assunção MCF, Orlandi SP. Validação da versão em português da avaliação subjetiva global produzida pelo paciente. Rev Bras Nutr Clin. 2010;25(2):102-8.

Sociedade Brasileira de Nutrição Oncológica. I Consenso Brasileiro de Nutrição Oncológica da SBNO. Rio de Janeiro: Edite; 2021.

Acuña K, Cruz T. Avaliação do estado nutricional de adultos e idosos e situação nutricional da população brasileira. Arq Bras Endocrinol Metab. 2004;48(3):345-61.

Wang WJ, Li TT, Wang X., Li W, Cui JW. Combining the Patient-Generated Subjective Global Assessment (PG-SGA) and objective nutrition assessment parameters better predicts malnutrition in elderly patients with colorectal cancer. J Nutr Oncol. 2020;5(1):22-30.

Steemburgo T, Averbuch NC, Belin CHS. Força de preensão manual e estado nutricional em pacientes oncológicos hospitalizados. Rev Nutr. 2018;31(5):489-99.

Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition – A consensus reportfrom the global clinicalnutrition community. Clin Nutr. 2018;(1):1-9.

Contreras-Bolívar V, Sánchez-Torralvo FJ, Ruiz-Vico M, González-Almendros I, Barrios M, Padín S, et al. GLIM criteria using hand grip strength adequately predict six-month mortality in cancer in patients. Nutrients. 2019;11(9):243.

De Groot LM, Lee G, Ackerie A, van der Meij BS. Malnutrition screeningand assessment in the câncer care ambulatory setting: mortality predictability and validity of the Patient-Generated Subjective Global Assessment Short form (PG-SGA SF) and the GLIM criteria. Nutrients. 2020;12(8):2287.

Instituto Brasileiro de Geografia e Estatística. Censo Demográfico 2010: resultados Preliminares do Universo. Rio de Janeiro: Instituto; 2011.

Lohman TG, Martorell R, Roche AF. Anthropometric standar dization reference manual. Illinois: Human Kinetics Books; 1988.

World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Commitee. World Health Organ Tech Rep Ser. 1995;8541:1-452.

Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1):55-67.

Frisancho, A. R. Anthropometric standard for the assessment of growth and nutritional status. Michigan: University of Michigan Press, 1990.

Blackburn GL, Thornton PA. Nutritional assessment of the hospitalized patient. Med Clin North Am. 1979;14:1102-08.

Luna-Heredia E, Martín-Peña G, Ruiz-Galiana J. Handgrip dynamometry in healthy adults. Clin Nutr. 2005;24(2):250-8.

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederhoml T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.

Douglas E, Mcmillan D. Towards a simple objective framework for the investigation and treatmentof câncer cachexia: the Glasgow Prognostic Score. Cancer Treat Rev. 2014;40:685-91.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Inquérito brasileiro de nutrição oncológica. Rio de Janeiro: Instituto; 2013.

Brito JE, Burgel CF, Lima J, Chites VS, Saragiotto CB, Rabito EI, et al. GLIM criteria for malnutrition diagnosis of hospitalized patients presents satisfactory criterion validity: a prospective cohort study. Clin Nutr. 2021;40(6):4366-72.

Henrique JR, Pereira RG, Ferreira RS, Keller H, Schueren MVD, et al. Pilot study Glim criteria for categorization of a malnutrition diagnosis of patients under going elective gastrointestinal operations: a pilot study of applicability and validation. Nutrition. 2020;79-80:110961.

Zhang L, Lu Y, Fang Y. Nutritional status and related factors of patients with advanced gastrointestinal cancer. Br J Nutr. 2014;111(7):1239-44.

Published

2023-10-27

How to Cite

SOLON, L. A., GOMES, K. P., LUZ, M. C. L. D., TOMIYA, M. T. O., CAMPOS, S. B. G., & ARRUDA, I. K. G. de. (2023). Comparison between GLIM and PG-SGA methods in the nutritional assessment of hospitalized oncological patients. Brazilian Journal of Nutrition, 36. Retrieved from https://periodicos.puc-campinas.edu.br/nutricao/article/view/10196

Issue

Section

ORIGINAL ARTICLE