Malnutrition defined by global leadership initiative on malnutrition criteria impedes home discharge in acute care hospital admissions

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2024-11, Vol.43 (11), p.112-119
• Main Authors: Saijo, Takeshi, Mori, Daisuke, Okamoto, Tomomi, Matsumoto, Kiyomi, Sate, Hiromi, Fujino, Kohei, Takeuchi, Hiroki, Sakai, Shiho, Ando, Ryo, Momoki, Chika, Habu, Daiki, Ryomoto, Kayoko
• Format: Article
• Language: English
• Subjects: Acute care; Aged; Aged, 80 and over; Discharge outcomes; Female; GLIM criteria; Hospital Mortality; Hospitalization - statistics & numerical data; Humans; Japan - epidemiology; Male; Malnutrition; Malnutrition - diagnosis; Malnutrition - epidemiology; Middle Aged; Nutrition Assessment; Patient Discharge - statistics & numerical data; Propensity score matching; Regional hospital; Retrospective Studies
• ISSN: 0261-5614; 1532-1983; 1532-1983
• DOI: 10.1016/j.clnu.2024.09.040

Limited evidence exists on the association between malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria in hospitalized acute care patients and their outcomes; several aspects still require clarification. This study aimed to evaluate the relationship between malnutrition, as defined by the GLIM criteria, at the time of acute hospital admission and discharge to home. This retrospective observational study was conducted at a hospital that provides acute care in Japan. Adult patients admitted between July 2023 and April 2024 were included in this study. The primary outcome was the number of patients discharged to home, with in-hospital mortality as the secondary outcome. To ensure the reliability of the cohort-wide results, background factors were adjusted using propensity score matching. The two groups were compared based on the presence or absence of malnutrition, as defined by the GLIM criteria at admission. Furthermore, multiple logistic regression analysis was conducted, with the outcome as the dependent variable and malnutrition, diagnosed using the GLIM criteria, as the explanatory variable, adjusting for covariates. A total of 1007 patients were included in the final analysis, of whom 492 (49 %) were diagnosed without malnutrition, while 515 (51 %) were diagnosed with malnutrition according to the GLIM criteria. In the multivariate logistic regression analysis after matching, malnutrition defined by the GLIM criteria emerged as an independent factor associated with discharge to home (odds ratio [OR] = 0.37, 95 % confidence interval = 0.25–0.56, P