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.

Duke Scholars

Author Paul Edmund Wischmeyer Anesthesiology, Critical Care Medicine

Author Krista Lynn Haines Trauma, Acute, and Critical Care Surgery