Data_Sheet_1_Validation of GLIM criteria on malnutrition in older Chinese inpatients.pdf

ObjectiveMalnutrition is a nutritional disorder and common syndrome that has a high incidence and is easily ignored in hospitalized older patients. It can lead to multiple poor prognoses, such as frailty. Early identification and correct evaluation of possible malnutrition and frailty are essential to improve clinical outcomes in older patients. Therefore, our objective was to explore the applicability and effectiveness of the Global Leadership Initiative on Malnutrition (GLIM) criteria for identifying malnutrition in older patients.MethodsIn total, 223 participants aged ≥60 years were involved. Nutrition was evaluated using the Mini Nutritional Assessment-Full Form (MNA-FF) and GLIM criteria, which adopt a two-step procedure. The first step was to use three different methods for the screening of nutritional risk: the Nutrition Risk Screening 2002, the Mini Nutritional Assessment Short Form (MNA-SF), and the Malnutrition Universal Screening Tool. The second step was to link a combination of at least one phenotypical criterion and one etiological criterion to diagnose malnutrition. The Clinical Frailty Scale was used to assess frailty. Sensitivity, specificity, Youden index, kappa values, and positive and negative predictive values were used to evaluate the validity of the GLIM criteria. Logistic regression models were used to assess whether there was a correlation between malnutrition, as defined by the GLIM criteria, and frailty.ResultsWe found that 32.3–49.8% of our patient sample were at risk of malnutrition based on the GLIM diagnosis and using the three different screening tools; 19.3–27.8% of the patients were malnourished. GLIM criteria with MNA-SF as a diagnostic validation and MNA-FF as a reference showed high consistency (K = 0.629; p ConclusionsThe incidence of GLIM-defined malnutrition was 19.3–27.8% using different screening tools. The consistency between the GLIM criteria using the MNA-SF and the MNA methods was high. Malnutrition, as diagnosed by the GLIM criteria with MNA-SF, was significantly correlated with frailty. GLIM criteria with MNA-SF may be a more reliable malnutrition assessment process in older inpatients.</p

Additional file 1 of Bidirectional two-sample mendelian randomization analysis identifies causal associations of MRI-based cortical thickness and surface area relation to NAFLD

Supplementary Material

Flow diagram of literature search.

<p>Flow diagram of literature search.</p

Forest plot for blood loss.

<p>The intraoperative blood loss with the harmonic scalpel was shorter than that with conventional hemostasis, but not significantly, and the statistical heterogeneity was unacceptably large (I² = 100%).</p

Forest plot for blood loss(sensitivity analysis).

<p>Heterogeneity became acceptable (I² = 0%) and the effect measure was significant(P<0.00001).</p

Forest plot for the amount of drainage (sensitivity analysis).

<p>Heterogeneity became acceptable (I² = 0%) but the effect measure was not significant (P = 0.58).</p

Forest plot for the amount of drainage.

<p>Total drainage fluid volume with the harmonic scalpel was significantly shorter than that with conventional hemostasis but the statistical heterogeneity was unacceptably large (I² = 97%).</p

Forest plot for operative time.

<p>The operative time with the harmonic scalpel was significantly shorter than that with conventional hemostasis, but the statistical heterogeneity was unacceptably large (I² = 92%).</p

Forest plot for the operative time (sensitivity analysis).

<p>Heterogeneity became acceptable (I² = 48%) and the effect measure remained significant (P<0.00001).</p

Risk of bias summary.

<p>Two studies were identified as being of a higher design quality. Three studies were identified as being of a lower design quality. The quality of the remaining two studies was moderate. (“+”means the bias is low risk, “?” means the bias is unclear).</p