Standardising and Simplifying the Global Leadership Initiative on Malnutrition (GLIM) for Its More General Application

Study Overview
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Brief Summary
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This observational study of aims to test whether and how the results of GLIM change when using different approaches and methods to carry out its components.

Detailed Description
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The main questions the study aims to answer are: What is the most effective pre-GLIM screening approach? Which of the simple, globally accessible muscle mass measurement methods works the best in the context of GLIM? How does using simpler approaches to screening and muscle mass measurement affect the performance of GLIM in detecting Subjective Global Assessment (SGA) defined malnutrition and 1-year mortality? Participants will be/have: asked questions about their recent food intake and possible non-volitional weight loss assessed for malnutrition with SGA weighed, and their height will be measured (if not already recorded) their muscle mass measured with a measuring tape (mid-upper arm circumference and calf circumference) and bioelectrical impedance their muscle function measured using hand grip strength have their patient records looked at to extract their weight and height data (if present), diagnoses, routine blood test results, abdominal computed tomography (CT) scan (if present), dual-energy x-ray absorptiometry (DEXA) scan (if present), 1-year mortality and personal identification code for documentation (the latter will be deleted when the study period is over).

Official Title
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Standardising and Simplifying the Global Leadership Initiative on Malnutrition (GLIM) for Its More General Application

Conditions
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Malnutrition

Intervention / Treatment
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* Diagnostic Test: Nutrition screening and assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age of 18+ years Able and willing to sign the consent form Inpatients of the Tartu University Hospital Admitted within 72 hours before enrolment Exclusion Criteria: Age of <18 years Inability or refusal to sign the consent form Pregnant or lactating women More than 72 hours passed since admission Patients isolating with an infection

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Inpatients of the Tartu University Hospital<br>Inclusion Criteria: Age of 18+ years, able and willing to sign the consent form, inpatients of the Tartu University Hospital, admitted within 72 hours before enrolment. Exclusion Criteria: Age of <18 years, inability or refusal to sign the consent form, pregnant or lactating women, more than 72 hours passed since admission, patients isolating with an infection. | Diagnostic Test: Nutrition screening and assessment<br>* The patient is interviewed for changes in body weight in the last six months and food intake in the last two weeks. The investigator evaluates the patient's diet, symptoms related to their nutritional status, and functional capacity according to the Subjective Global Assessment (SGA). The SGA tool itself is completed by the researcher. Height and weight of the patient are measured, if not yet recorded, and BMI is calculated. The patient's muscle mass is measured using mid-upper arm circumference (MUAC), calf circumference (CC) and bioelectrical impedance (BIA), and their muscle function assessed using hand grip strength.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Subjective Global Assessment (SGA) defined malnutrition | Subjective Global Assessment (SGA) can be considered a method that is close to a gold standard for malnutrition assessment. Therefore, the study will analyse how different approaches to screening and muscle mass measurement affect the performance of GLIM in detecting Subjective Global Assessment (SGA) defined malnutrition. | baseline, pre-intervention/procedure/surgery | 
| One-year mortality | One year after the data collection, we will look at the patient records to collect the 1-year mortality data. This will give information about whether and how different approaches to components of GLIM affect its ability to predict one-year mortality. | through study completion, an average of 1 year | 
| Computed tomography (CT) defined muscle mass | One of the GLIM criteria is reduced muscle mass, and this study will investigate how muscle mass measured with simpler methods compares against muscle mass measured with CT. | baseline, pre-intervention/procedure/surgery | 
| DEXA defined muscle mass | One of the GLIM criteria is reduced muscle mass, and this study will investigate how muscle mass measured with simpler methods compares against muscle mass measured with DEXA. | baseline, pre-intervention/procedure/surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bioelectrical impedance (BIA) defined muscle mass | One of the GLIM criteria is reduced muscle mass, and this study will investigate how muscle mass measured with simpler methods compares against muscle mass measured with BIA. | baseline, pre-intervention/procedure/surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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GLIM criteria, GLIM, nutrition assessment, nutrition screening, muscle mass