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  • Artigo Científico
    How Reliable Are The Screening Tools As A Triage Element For The Application Of The Global Leadership Initiative On Malnutrition (Glim)? Prospective Multicenter Observational Study
    (2023) Lopes, G.G.; Piovacari, S. M. F.; Moraes, J. R.; Santos, H. B. C.; Rakovicius, A. K. Z.; ANDRE FILIPE DE MORAES BATISTA; Pereira, A.J.
    Rationale: The international GLIM guideline recommends on the use of nutritional screening for the diagnosis of hospital malnutrition. However, as clinical outcomes were not included in the original validation of these instruments and their sensitivity (true positive rate) is unknown, it is not possible to report a chance of a truly at nutritional risk patient not being identified by screening and consequently not being evaluated by the GLIM. Methods: Multicenter, prospective observational trial in 3 Brazilian tertiary hospitals, carried out between December/21 to February/22. A convenience sample was used based on patients with expected length of stay at hospital longer than 48 hours. Pregnant women, under 18 years old, palliative care, lymphedema and muscle atrophy of neurological causes patients were excluded. NRS 2002, MNA-SF and ESPEN 2019 tools were applied to the specific populations (following international guidelines) by trained and validated Dietitians. Hospital mortality data were extracted from the local electronic medical records. Results: 676 patients were included, 54% male, 90% white with a mean age of 63 years (SD: ±21) and BMI of 27.50 kg/m2 (SD: ±4.72), hospitalized in the wards (68%). The most used nutritional screening was NRS 2002 (52%). In the sample, 39% were at nutritional risk, of these 5.6% died. An overview of nutritional screening tools’ performance are shown in the Table. In addition, accuracy found was 0.59 and area under the curve was 0,69 for predicting in-hospital deaths.