Prediction of 5-year mortality risk by malnutrition according to the GLIM format using seven pragmatic approaches to define the criterion of loss of muscle mass
Sanchez Rodriguez, Maria Dolores Carmen; Locquet, Médéa; Bruyère, Olivieret al.
2021 • In Clinical Nutrition, 40 (4), p. 2188-2199
Prediction of 5-year mortality risk by malnutrition according to the GLIM format using seven pragmatic approaches to define the criterion of loss of muscle mass.pdf
[en] Objectives: To assess the association between baseline malnutrition according to the GLIM format, using seven pragmatic approaches to define the criterion of loss of muscle mass, with mortality in the SarcoPhAge (Sarcopenia and Physical Impairment with advancing Age) study during a 5-year follow-up. Secondarily, to calculate diagnostic performance indicators, concordance, and feasibility of these 7 pragmatic approaches compared to the original GLIM criteria.
Methods: Post-hoc analysis of the SarcoPhAge cohort, which included 534 community-dwelling volunteers ≥ 65-year-old, followed-up from 2013 to 2019. Baseline malnutrition was defined by GLIM criteria and 7 approaches: 1) Omission of a reduced muscle mass as a criterion; 2) Substitution for handgrip strength, 3) Calf-circumference, 4) Mid-arm circumference, 5) Goodman's grid, 6) Ishii's score chart, and 7) Yu's formula. The association between malnutrition (according to GLIM criteria and the 7 approaches) and mortality was assessed by Cox-regressions. Sensitivity, Specificity, Positive (PPV), Negative (NPV) predictive values, area under the curve (AUC), Cohenekappa coefficient, and TELOS-feasibility score were calculated.
Results: Data to calculate GLIM criteria were available for 373 subjects (73.07 ± 5.96 years, 56% women).
Prevalence of malnutrition with GLIM criteria was 24.4% (ranged from 13.9% to 20.9% with the 7 approaches). GLIM criteria showed a HR ¼ 3.38 (1.89-6.09) to predict mortality during the 5-year follow-up which ranged from HR = 2.72 (1.51 - 4.91) to 3.94 (2.14 - 7.24) with the 7 approaches. All 7 approaches were feasible (TELOS ≥ 3), showed sensitivity ≥ 65%, specificity ≥ 95.4%, PPV ≥ 85%, NPV ≥ 88%, AUC ≥ 0.7 and had almost-perfect/strong concordance (k ≥ 0.7) with the original GLIM criteria.
Conclusions: GLIM criteria and the 7 approaches predicted three-to four-fold mortality, all ensured an accurate diagnosis, and were feasible in clinical settings.
Disciplines :
General & internal medicine Public health, health care sciences & services
Author, co-author :
Sanchez Rodriguez, Maria Dolores Carmen ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Locquet, Médéa ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie clinique
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Lengele, Laetitia ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
CAVALIER, Etienne ; Centre Hospitalier Universitaire de Liège - CHU > Unilab > Service de chimie clinique
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Beaudart, Charlotte ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Prediction of 5-year mortality risk by malnutrition according to the GLIM format using seven pragmatic approaches to define the criterion of loss of muscle mass
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