Comparison of mNutric score,NRS-2002 score,and SGA score with the gold standard GLIM criteria in the diagnosis of malnutrition

Abstract

Background: Malnutrition is a common problem in aging populations. Studies show that up to one-third of hospital patients are affected. Malnutrition is linked to various health concerns, including poor muscle function, decreased bone density, immunological dysfunction, cognitive decline, anemia, prolonged hospital admissions, and higher morbidity and mortality. Aim: This study compares the diagnostic performance of the Nutritional Risk Screening 2002 (NRS-2002) score, Subjective Global Assessment (SGA) score, and Nutrition Risk in the Critically Ill (modified Nutric score [mNutric]) score with the gold standard Global Leadership Initiative on Malnutrition (GLIM) criteria in diagnosing malnutrition. Methods: The current study was conducted over the period of two months at S. L. Raheja Hospital and included 100 patients over the age of 18. Within the first 24 h after admission, malnutrition screening was performed using NRS-2002, SGA, and mNutric scores, with GLIM criteria as the reference. Results: The GLIM criteria identified 41% of patients as malnourished, but SGA and NRS-2002 revealed 60% and 72%, respectively, and mNutric as 40%. Kappa coefficients demonstrated good agreement between GLIM and mNutric (k = 0.915), moderate agreement with NRS-2002 (k = 0.761), and reasonable agreement with SGA (k = 0.632). Sensitivity and specificity analyses revealed that GLIM has superior diagnostic accuracy. Conclusion: These findings support GLIM criteria as a global standard for malnutrition diagnosis, enhancing clinical outcomes through targeted nutritional interventions. The GLIM criteria demonstrated better agreement with the mNutric score compared to the other two tools. However, incorporating all available screening tools in clinical practice will enhance the early detection of malnutrition.