Objective To analyze the consistency of Global Leadership Initiative on Malnutrition (GLIM) standard, Patient-generated Subjective Global Assessment (PG-SGA) and serum albumin (ALB) in diagnosis of malnutrition in cancer patients.
Methods From January to December 2020, a total of 218 cancer patients were randomly selected from the first People′s Hospital of Yibin City in Sichuan Province, and their malnutrition states were diagnosed by GLIM standard, PG-SGA and serum ALB, respectively. The consistency of three methods in diagnosing malnutrition was compared.
Results ① The score of Nutrition Risk Screening Tool 2002 (NRS 2002) in 218 cancer patients was (3.12±1.08) points, and the incidence of nutritional risk was 53.67% (117/218). There was significant differences in incidence of nutritional risk among patients with different age groups, tumor types and tumor stages (P < 0.05). ② Among the five phenotypes of GLIM standard, the incidences of weight loss, low body mass index, muscle loss, decreased food intake or digestive dysfunction, and disease or inflammatory burden were 44.04%(96/218), 16.51%(36/218), 42.20%(92/218), 77.06% (168/218) and 40.37% (88/218), respectively. A total of 81 cases were diagnosed as malnutrition according to GLIM standard, and the positive rate was 37.16%. There were significant differences in the incidences of malnutrition among patients with different age groups, tumor types and tumor stages (P < 0.05 or P < 0.01). ③ A total of 95 cases were diagnosed as malnutrition by PG-SGA, and the positive rate was 43.58%; a total of 87 cases were diagnosed as malnutrition according to standard of ALB < 35 g/L, and the positive rate was 39.91%; there were significant differences in the incidences of malnutrition among patients with different age groups, tumor types and tumor stages (P < 0.05 or P < 0.01). ④ Taking GLIM as the gold standard, the Kappa value of PG-SGA in the diagnosis of malnutrition was 0.73, and the sensitivity and specificity were 91.4% and 84.7% respectively; the Kappa value of ALB in the diagnosis of malnutrition was 0.75, and the sensitivity and specificity were 87.7% and 88.3% respectively.
Conclusion The incidences of nutritional risk and malnutrition are high in cancer patients. GLIM standard is consistent with PG-SGA and ALB in the diagnosis of malnutrition, and it is necessary to reasonably select diagnostic tools according to the situation in clinical application.
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