GLIM criteria represents a more suitable tool to evaluate the nutritional status and predict postoperative functional recovery of older patients with hip fracture

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Abstract
Purpose: Early recognition of malnutrition is of prime importance and essential for improving the prognosis of older patients with hip fracture. The Nutritional Risk Screening 2002 (NRS-2002), The Short-Form Mini Nutritional Assessment (MNA-SF) and The Global Leadership Initiative on Malnutrition (GLIM) are widely used in malnutrition diagnose. However, the criteria for predicting postoperative hip joint function in aging patients with hip fractures during a long-term is still necessary. The objective of this study was to select the most appropriate criteria from the NRS-2002, the MNA-SF and the GLIM in predicting the postoperative recovery of hip joint function in a long-term. Methods: This retrospective observational study included the 161 patients aged ≥65 years with hip fracture. Nutritional states of the patients were determined by the NRS-2002, the MNA-SF and the GLIM. The Harris Hip Joint Score (HHS), the primary outcome of this study, was used to evaluate the hip joint function. The HHS was classified into good recovery (HHS>75) and bad recovery (HHS<=75). Logistic regression models for hip joint function recovery were constructed. Both the ROC and the DCA were used to select the most predictive criteria. Results: The overall mean age of the 161 patients was 77.90 ± 8.17. As a result, all of the NRS-2002 (OR: 0.06, 95%CI [0.01, 0.17]), the MNA-SF (OR: 0.05, 95%CI [0.00, 0.23]) and the GLIM (OR of moderate: 0.03, 95%CI [0.01, 0.11]; OR of severe: 0.02 [0.00, 0.07]) were predictive for recovery of hip joint function. Additionally, both the AUC of ROC (NRS-2002: 81.2 [73.8, 88.6], MNA-SF: 76.3[68.5, 84.2], GLIM: 86.2 [79.6,92.8]) and the DCA showed the GLIM was better than others. Conclusion: Compared with NRS-2002 and MNA-SF, GLIM was a better nutritional assessment criteria to predict the postoperative recovery of hip joint function for older hip fracture patients in a long-term.

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