• Gislaine Aparecida Ozorio, RibeiroLia Mara KauchiLMKNutrition and Dietetics Service, Cancer Institute of the State of São Paulo, São Paulo, Brazil., Bárbara Chaves Santos, Wânnia Ferreira de Sousa Bruzaca, Gabriela Del Gallo Vieira da Rocha, Luani Maria da Fonseca Marchi, Fernando Magri Santos, Alves de AlmeidaMaria Manuela FerreiraMMFNutrition and Dietetics Service, Cancer Institute of the State of São Paulo, São Paulo, Brazil., KulcsarMarco Aurélio VamondesMAVDepartment of Head and Neck Surgery, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil., JuniorUlysses RibeiroURDepartment of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil., CorreiaMaria Isabel Toulson DavissonMITDGraduate Program in Surgery, Federal University of Minas Gerais, Minas Gerais, Brazil., and Dan Linetzky Waitzberg.
• Nutrition and Dietetics Service, Cancer Institute of the State of São Paulo, São Paulo, Brazil. Electronic address: gislaineozorio@gmail.com.
• Nutrition. 2023 Dec 1; 116: 112195112195.

ObjectivesThe Global Leadership Initiative on Malnutrition (GLIM) criteria establish a diagnosis of malnutrition based on the presence of at least one phenotypic and one etiologic criterion. This study aimed to assess the concurrent and predictive validity of the GLIM criteria in hospitalized cancer patients.MethodsThis is an observational retrospective study, including 885 cancer patients, ages >18 y, admitted to a medical oncology inpatient unit between 2019 and 2020. All patients at risk for malnutrition according to the Nutritional Risk Screening 2002 score were assessed by the subjective global assessment (SGA) and 14 different combinations of the GLIM criteria. The SGA was considered the gold standard for assessing the concurrent validity of the GLIM combinations. For a subsample of patients with data available on inflammatory markers (n = 198), the serum albumin and C-reactive protein were included in the combinations as etiologic criteria. The predictive validity of the different combinations was tested using the occurrence of surgical complications as the clinical outcome. The sensitivity and specificity values were calculated to assess the concurrent validity, univariate and multivariate logistic regression models were used to test predictive validity. Adequate concurrent and predictive validity were determined as sensitivity and specificity values >80% and odds ratio values ≥2.0, respectively.ResultsThe median age of the patients was 61.0 y (interquartile range = 51.0-70.0). Head and neck cancer was the prevailing diagnosis and 375 patients were at nutritional risk. According to the SGA, 173 (26.1%) patients were malnourished (SGA categories B or C) and the prevalence of malnutrition ranged from 3.9% to 30.0%, according to the GLIM combinations. None of the tested combinations reached adequate concurrent validity; however, the presence of malnutrition according to four combinations independently predicted surgical complications.ConclusionsThe predictive validity of the GLIM was satisfactory in surgical cancer patients.Copyright © 2023 Elsevier Inc. All rights reserved.

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