The predictive power of postoperative complications and the agreement between PG-SGA SF and GLIM in identifying malnourishment in patients with pancreatic diseases before pancreatic surgery

Q3 Nursing

Clinical Nutrition Open Science Pub Date : 2025-03-20 DOI:10.1016/j.nutos.2025.03.005

Martina Petrolo , Mia Solholt Godthaab Brath , Randi Tobberup , Sofie Ehlers , Marie Njerve Olsen , Elena Rangelova , Lars Ellegård , Folke Hammarqvist , Henrik Højgaard Rasmussen

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Abstract

Background

Patients with pancreatic diseases impose several nutritional challenges and identifying malnourished patients is important since malnutrition may increase the risk of postoperative complications.

Aims

To assess the agreement between Patient Generated-Subjective Global Assessment Short Form (PG-SGA SF) and Global Leadership Initiative on Malnutrition (GLIM) criteria in identifying malnutrition in patients with pancreatic diseases scheduled for elective surgery. To investigate whether there is an association between malnutrition and postoperative complications.

Methods

A secondary analysis of a prospective observational cross-sectional study in patients with pancreatic diseases undergoing pancreatic surgery from September 2017 to January 2018 at Karolinska University Hospital (Stockholm, Sweden). Nutritional screening was performed by PG-SGA SF and malnutrition diagnosis was defined by GLIM with and without prior screening.

Results

A total of 34 patients were included (16 men, 18 women), median age 70 (range 38–83) years, median BMI 24.4 (range 19.3–40.4) kg/m². Risk of malnutrition was detected in 14 patients (41 %) by PG-SGA SF. Malnutrition was detected in 9 patients (26 %) by GLIM with prior screening (GLIM + screening) and in 17 patients (50 %) by GLIM without prior screening (GLIM - screening). The agreement between PG-SGA SF and GLIM - screening was 62 %, the sensitivity 64 %, the specificity 60 %, and the Cohen's kappa was 0.235, P=0.08. GLIM - screening had a positive predictive value of 53 % and negative predictive value of 71 %. A total of 14 patients had postoperative complications. The GLIM - screening showed a RR of 1.40 (CI: 0.58–3.37) of postoperative complications when being malnourished. The GLIM + screening showed a RR of 1.66 (CI: 0.49–5.61) of postoperative complications when being malnourished.

Conclusions

This study showed that PG-SGA SF and GLIM had a slight to fair agreement in detecting malnutrition in patients undergoing pancreatic resection. No firm conclusions in predicting postoperative complications could be found.

查看原文本刊更多论文

胰腺术后并发症的预测能力以及PG-SGA SF和GLIM在胰腺手术前识别胰腺疾病患者营养不良方面的一致性

背景：胰腺疾病患者面临多种营养挑战，由于营养不良可能增加术后并发症的风险，因此确定营养不良患者非常重要。目的评估患者主观总体评估简表（PG-SGA SF）和全球营养不良领导倡议（GLIM）标准在确定计划择期手术的胰腺疾病患者营养不良方面的一致性。探讨营养不良与术后并发症之间是否存在关联。方法对2017年9月至2018年1月在瑞典斯德哥尔摩卡罗林斯卡大学医院（Karolinska University Hospital）接受胰腺手术的胰腺疾病患者的前瞻性观察性横断面研究进行二次分析。营养筛查由PG-SGA SF进行，营养不良诊断由GLIM确定，有或没有事先筛查。结果共纳入34例患者（男16例，女18例），中位年龄70（38 ~ 83）岁，中位BMI 24.4 (19.3 ~ 40.4) kg/m2。PG-SGA SF检测到14例（41%）患者存在营养不良风险。经GLIM预先筛查（GLIM +筛查）的患者中有9例（26%）发现营养不良，未经GLIM预先筛查（GLIM -筛查）的患者中有17例（50%）发现营养不良。PG-SGA SF与GLIM筛查的符合性为62%，敏感性为64%，特异性为60%，Cohen’s kappa为0.235，P=0.08。GLIM筛查阳性预测值为53%，阴性预测值为71%。术后并发症14例。GLIM筛查显示营养不良患者术后并发症的RR为1.40 （CI: 0.58-3.37）。GLIM +筛查显示营养不良患者术后并发症的RR为1.66 （CI: 0.49-5.61）。结论本研究显示PG-SGA、SF和GLIM在胰腺切除术患者营养不良的检测上有一定的一致性。在预测术后并发症方面没有明确的结论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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