Malnutrition defined by GLIM criteria identifies a higher incidence of malnutrition and is associated with pulmonary complications after oesophagogastric cancer surgery, compared to ICD-10-defined malnutrition

Journal article

Murnane, Lisa C., Forsyth, Adrienne K., Koukounaras, Jim, Shaw, Kalai, King, Susannah, Brown, Wendy A., Mourtzakis, Marina, Tierney, Audrey C. and Burton, Paul R.. (2023). Malnutrition defined by GLIM criteria identifies a higher incidence of malnutrition and is associated with pulmonary complications after oesophagogastric cancer surgery, compared to ICD-10-defined malnutrition. Journal of Surgical Oncology. pp. 1-12. https://doi.org/10.1002/jso.27366
AuthorsMurnane, Lisa C., Forsyth, Adrienne K., Koukounaras, Jim, Shaw, Kalai, King, Susannah, Brown, Wendy A., Mourtzakis, Marina, Tierney, Audrey C. and Burton, Paul R.
Abstract

Background & Objectives
Low muscle mass, measured using computed tomography (CT), is associated with poor surgical outcomes. We aimed to include CT-muscle mass in malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria, compare it to the International Classification of Diseases 10th Revision (ICD-10) criteria, and assess the impact on postoperative outcomes after oesophagogastric (OG) cancer surgery.

Methods
One hundred and eight patients who underwent radical OG cancer surgery and had preoperative abdominal CT imaging were included. GLIM and ICD-10 malnutrition data were assessed against complication and survival outcomes. Low CT-muscle mass was determined using predefined cut-points.

Results
GLIM-defined malnutrition prevalence was significantly higher than ICD-10-malnutrition (72.2% vs. 40.7%, p < 0.001). Of the 78 patients with GLIM-defined malnutrition, low muscle mass (84.6%) was the predominant phenotypic criterion. GLIM-defined malnutrition was associated with pneumonia (26.9% vs. 6.7%, p = 0.010) and pleural effusions (12.8% vs. 0%, p = 0.029). Postoperative complications did not correlate with ICD-10 malnutrition. Severe GLIM (HR: 2.51, p = 0.014) and ICD-10 (HR: 2.15, p = 0.039) malnutrition were independently associated with poorer 5-year survival.

Conclusions
GLIM criteria appear to identify more malnourished patients and more closely relate to surgical risk than ICD-10 malnutrition, likely due to incorporating objective muscle mass assessment.

Keywordscancer surgery; esophageal; gastric; GLIM criteria; malnutrition; muscle mass
Year2023
JournalJournal of Surgical Oncology
Journal citationpp. 1-12
PublisherWiley Periodicals
ISSN1096-9098
Digital Object Identifier (DOI)https://doi.org/10.1002/jso.27366
PubMed ID37291908
Scopus EID2-s2.0-85161640621
Open accessPublished as ‘gold’ (paid) open access
Page range1-12
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online09 Jun 2023
Publication process dates
Accepted24 May 2023
Deposited08 Aug 2023
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