ArticleJPEN. Journal of parenteral and enteral nutrition2026
Association between GLIM-defined malnutrition and in-hospital costs in adults with sepsis: A sub analysis of a prospective cohort study.
Article in JPEN. Journal of parenteral and enteral nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInternational statements suggest using the Global Leadership Initiative on Malnutrition (GLIM) criteria in intensive care units (ICUs); however, the economic impact of GLIM-defined malnutrition in sepsis remains unclear. This study investigated the association between GLIM-defined malnutrition and in-hospital costs in sepsis.
methodsWe conducted a sub-analysis of the prospective cohort study, Investing Long-term Outcomes of Sepsis or Septic shock, among medically managed critically ill patients with sepsis in 15 Japanese ICUs. Associations between GLIM-defined malnutrition and cost categories (low, moderate, and high) were assessed using multinomial logistic regression (reference: low-cost group), adjusted for age, sex, Charlson Comorbidity Index, and Sequential Organ Failure Assessment score. Individual GLIM components were also examined. Total in-hospital costs and secondary outcomes were compared between malnutrition and non-malnutrition groups using inverse probability of treatment weighting.
resultsAmong 259 patients, 111 had GLIM-defined malnutrition. GLIM-defined malnutrition was associated with both the moderate-cost (adjusted odds ratio [AOR]: 2.03, 95% confidence interval [CI]: 1.05-3.89) and high-cost classifications (AOR: 2.27, 95% CI: 1.20-4.29). Among GLIM components, reduced muscle mass (AOR: 1.95, 95% CI: 1.04-3.68) and reduced food intake (AOR: 2.61, 95% CI: 1.39-4.92) were associated with the high-cost classification. After weighting, the malnutrition group had significantly higher median in-hospital costs (24,959 vs. 18,651 USD), longer hospital stays, and longer ICU stays than the non-malnutrition group.
conclusionsGLIM-defined malnutrition-particularly reduced muscle mass and reduced food intake-was associated with higher in-hospital costs in sepsis and may be a potential indicator of high-cost hospitalization.
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