Clinical nutrition (Edinburgh, Scotland) · 2026
Malnutrition defined by the GLIM criteria predicts increased mortality and prolonged hospitalisation among intensive care unit patients: a nationwide database study.
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Ishida Yuria, Maeda Keisuke, Inoue Tatsuro, Murotani Kenta, Saito Araki, Kawase Fumiya, Nagano Ayano, Mori Naoharu
Аннотация
BACKGROUND & AIMS: Malnutrition is highly prevalent in patients admitted to the intensive care unit (ICU), and it is associated with poor outcomes. The Global Leadership Initiative on Malnutrition (GLIM) criteria provide internationally standardised diagnostic criteria; however, their prognostic value for ICU populations has not been investigated using nationwide real-world data.
METHODS: We conducted a retrospective cohort study using a nationwide administrative claims database including inpatient and outpatient data between April 2018 and November 2024. To ensure uniform application of the GLIM weight-loss criterion, patients aged 18-99 years who were admitted to ICU and had available information regarding weight changes within the preceding 6 months were included. Nutritional status was classified as no malnutrition, moderate malnutrition, or severe malnutrition according to the GLIM criteria. Primary outcomes were in-hospital mortality, overall mortality, length of hospital stay, and length of ICU stay.
RESULTS: A total of 6065 ICU patients were analysed (mean age: 74.4 ± 12.7 years; 63.6% male). The prevalence of GLIM-defined malnutrition was 85.4% (n = 5181). Compared with no malnutrition, severe malnutrition was independently associated with higher in-hospital mortality (subdistribution hazard ratio 1.58 [1.16-2.15], p = 0.004), higher overall mortality (hazard ratio 1.62 [1.32-1.99], p < 0.001), and longer length of hospital stay (+4.09 [2.72-5.46] days, p < 0.001). There was no significant difference in the length of ICU stay (+0.04 [-0.17-0.25] days, p = 0.724).
CONCLUSIONS: Severe GLIM-defined malnutrition may be associated with higher mortality and longer hospitalisation among ICU patients. This finding emphasises the importance of early standardised nutritional assessment.
METHODS: We conducted a retrospective cohort study using a nationwide administrative claims database including inpatient and outpatient data between April 2018 and November 2024. To ensure uniform application of the GLIM weight-loss criterion, patients aged 18-99 years who were admitted to ICU and had available information regarding weight changes within the preceding 6 months were included. Nutritional status was classified as no malnutrition, moderate malnutrition, or severe malnutrition according to the GLIM criteria. Primary outcomes were in-hospital mortality, overall mortality, length of hospital stay, and length of ICU stay.
RESULTS: A total of 6065 ICU patients were analysed (mean age: 74.4 ± 12.7 years; 63.6% male). The prevalence of GLIM-defined malnutrition was 85.4% (n = 5181). Compared with no malnutrition, severe malnutrition was independently associated with higher in-hospital mortality (subdistribution hazard ratio 1.58 [1.16-2.15], p = 0.004), higher overall mortality (hazard ratio 1.62 [1.32-1.99], p < 0.001), and longer length of hospital stay (+4.09 [2.72-5.46] days, p < 0.001). There was no significant difference in the length of ICU stay (+0.04 [-0.17-0.25] days, p = 0.724).
CONCLUSIONS: Severe GLIM-defined malnutrition may be associated with higher mortality and longer hospitalisation among ICU patients. This finding emphasises the importance of early standardised nutritional assessment.