Malnutrition Diagnosed via Global Leadership Initiative on Malnutrition (GLIM) Criteria - Association with Clinical Outcomes and Predictive Value: A Systematic Review of Systematic Reviews

Abstract

Objectives: Malnutrition is very common in people with cancer. The Global Leadership Initiative on Malnutrition (GLIM) recommendation on criteria has been proposed as a gold standard for diagnosing malnutrition. The diagnosis of malnutrition includes phenotypic criteria such as unintentional weight loss and etiologic criteria such as reduced food intake. The aim of this review is to summarise the evidence on the GLIM-defined malnutrition association with clinical outcomes and its predictive value.

Methods: A systematic search was conducted in PubMed, CINAHL, and MEDLINE databases. A total of 6 systematic reviews with and without meta-analysis were identified and included for analysis. Five were systematic reviews with meta-analyses and 1 systematic review without meta-analysis.

Results: GLIM-defined malnutrition is associated with decreased survival, disease-free survival, increased post-operative complications, increased overall complications, and prolonged length of stay. It has predictive value for worsening clinical outcomes.

Conclusion: The results support the use of GLIM criteria and indicate their predictive value for clinical outcomes. There is robust evidence indicating the association and predictive value of GLIM-defined malnutrition for clinical outcomes in people with cancer to recommend its use in clinical practice. Thus, the GLIM criteria depend on prior screening tools used and the consistency of muscle mass assessment.

Implications for nursing practice: Nutrition care is a fundamental aspect of cancer nursing practice and nurses need to be aware of the signs of malnutrition. The GLIM criteria are relevant to be used also in cancer nursing practice for the early detection of malnutrition among people with cancer.

Keywords: Cancer patient; Diagnosis; Malnutrition; Oncology nursing.