Effectiveness of GLIM and SGA for diagnosing malnutrition and predicting wound healing in patients with diabetic foot ulcers

This study aimed to compare the effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) and Subjective Global Assessment (SGA) in diagnosing malnutrition and predicting wound healing in patients with diabetic foot ulcers (DFU). GLIM criteria were evaluated for sensitivity (SE), specificity (SP), positive predictive value (PPV), negative PV (NPV), and kappa (κ) against SGA as the reference. Modified Poisson regression model and the DeLong test investigated the association between malnutrition and non-healing ulcers over six months. This retrospective cohort study included 398 patients with DFU, with a mean age of 66.3 ± 11.9 years. According to SGA and GLIM criteria, malnutrition rates were 50.8% and 42.7%, respectively. GLIM criteria showed a SE of 67.3% (95% CI: 60.4%, 73.7%) and SP of 82.7% (95% CI: 76.6%, 87.7%) in identifying malnutrition, with a PPV of 80.0% and an NPV of 71.1% (κ = 0.50) compared to SGA. Multivariate analysis demonstrated that malnutrition, as assessed by SGA, was an independent risk factor for non-healing (relative risk [RR] 1.84, 95% CI: 1.45, 2.34), whereas GLIM criteria were associated with poorer ulcer healing in patients with estimated glomerular filtration rate ≥60mL/min/1.73m2 (RR: 1.46, 95% CI: 1.10, 1.94). SGA demonstrated a superior AUROC for predicting non-healing compared to GLIM criteria [0.70 (0.65-0.75) vs. 0.63 (0.58-0.65), P <0.01]. These findings suggest that both nutritional assessment tools effectively ident...
Source: The British Journal of Nutrition - Category: Nutrition Authors: Source Type: research