GLIM-defined malnutrition and sarcopenia in hospitalized Indian patients with gastrointestinal diseases: A prospective 1-year follow-up study.

BACKGROUND: Hospitalized patients with gastrointestinal (GI) diseases are predisposed to malnutrition and sarcopenia due to inflammation, malabsorption, and reduced intake, resulting in prolonged hospitalization and increased mortality. AIMS: To determine the prevalence of malnutrition and sarcopenia among adult hospitalized GI patients using the Global Leadership Initiative on Malnutrition (GLIM) criteria, computed tomography (CT)-derived body composition, and handgrip strength (HGS), and to evaluate their associations with length of hospital stay and 1-year mortality. METHODS: A single-center prospective observational study of 847 consecutively hospitalized adults with medical GI diseases. Malnutrition was classified using GLIM criteria, and sarcopenia was assessed via CT-derived skeletal muscle index (SMI), and HGS. Asian cutoffs were applied, and follow-up at 1 year post-discharge. RESULTS: GLIM-defined malnutrition was identified in 65% of patients, low HGS in 54%, and low SMI in 44%. Overall, 28% had both low SMI and low HGS, consistent with sarcopenia. Low SMI was significantly associated with low HGS (P < 0.001). Compared with well-nourished patients, GLIM-malnourished patients had higher odds of low HGS (58.3% vs. 45.3%; OR 1.68, 95% CI 1.26-2.24; P < 0.001). One-year mortality was higher among malnourished patients (7.5% vs. 3.1%; P = 0.018). In forward stepwise multivariable logistic regression, GLIM-defined malnutrition remained independently associated with 1-year mortality after adjustment for age, primary diagnosis, and length of hospital stay (OR 2.56, 95% CI 1.14-5.76; P = 0.023). CONCLUSION: GLIM-defined malnutrition and sarcopenia are highly prevalent and associated with poor outcomes. Findings support integration of body composition, and HGS into routine nutritional assessments.