评估肺癌切除术患者的营养不良：对营养不良全球领导倡议（GLIM）标准的修改，以便在外科实践中实施。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-05 DOI:10.1016/j.clnesp.2025.09.003

Laura Gorenshtein , Sonal Swain , Jonathan Laredo , Trevor Sytsma , Ben Nguyen , Paul Wischmeyer , Krista L. Haines

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引用次数: 0

摘要

背景：高达70%的肺癌患者可能是营养不良。本研究旨在用改良的GLIM标准检查营养不良对肺癌切除术患者预后的影响。方法：采用mGLIM标准识别营养不良患者。修改后的标准包括(1)年龄≤70岁BMI≤20，年龄≥71岁BMI≤22，(2)过去6个月内体重减轻> 10%,(3)入院白蛋白≤3.5。满足所有三个标准的患者被归类为营养不良。这项研究的重点是接受选择性手术的肺癌患者。采用多变量模型评估mGLIM标准对多个结果的影响。结果：我们分析了37386例接受择期肺切除术的患者。55.60%为女性（n = 20787）， 73.35%为白人（n = 27421）， 6.30%为黑人或非裔美国人（n = 2354）。只有0.15% （n = 57）的人拥有所有三个mGLIM变量的数据。符合所有三项mGLIM标准的52例患者的结果是死亡。结论：根据mGLIM标准，营养不良的肺癌患者术后预后较差。虽然mGLIM是一种实际的适应，但我们的研究结果表明，完整的GLIM标准应该在临床实践中得到更广泛的应用。术前结合GLIM标准可以增强对营养不良患者的识别，允许更早，量身定制的营养干预。

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Assessing malnutrition in lung cancer resection patients: Modification of global leadership initiative on malnutrition (GLIM) criteria for implementation in surgical practice

Background

Up to 70 % of lung cancer may be malnourished. This study aims to examine the effects of malnutrition on outcomes in lung cancer patients undergoing resection using modified GLIM criteria.

Methods

The study utilized the mGLIM criteria to identify malnourished patients. The modified criteria included (1) BMI ≤20 for age ≤70 years and BMI ≤22 for age ≥71 years, (2) weight loss >10 % within the past 6 months, and (3) admission albumin ≤3.5. Patients meeting all three criteria were classified as malnourished. The study focused on lung cancer patients who underwent elective surgery. Multivariate models were employed to evaluate the impact of mGLIM criteria on multiple outcomes.

Results

We analyzed 37,386 patients who underwent elective lung resection from. 55.60 % were female (n = 20,787), 73.35 % White (n = 27,421), and 6.30 % Black or African American (n = 2354). Only 0.15 % (n = 57) had data available for all three mGLIM variables. 52 patients who met all three mGLIM criteria had mortality as an outcome. Malnourished patients experienced longer length of stay (p < 0.001, CI [2.40, 5.18]), increased complications (p < 0.001, CI [2.27, 6.87]), and increased discharge to facilities (p < 0.001, CI [1.80, 7.69].

Conclusion

Malnourished lung cancer patients, as per mGLIM criteria, experience worse post-operative outcomes. While mGLIM is a practical adaptation, our findings suggest that the full GLIM criteria should be more widely applied in clinical practice. Incorporating GLIM criteria preoperatively could enhance the identification of malnourished patients, allowing for earlier, tailored nutritional interventions.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.