Association between GLIM diagnosed malnutrition and 18‐month mortality in hospitalized adults with congestive heart failure: A prospective cohort study

BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) criteria have been validated in various clinical settings since 2018, but prospective validation in patients with congestive heart failure (CHF) who are hospitalized remains limited. This study compares the prognostic performance of the GLIM criteria and Mini-Nutritional Assessment (MNA)-defined malnutrition for all-cause mortality in CHF patients and explores the strongest predictive indicator within the GLIM criteria. METHODS: This single-center prospective cohort study included inpatients with CHF. Agreement between the GLIM criteria and MNA was assessed using Cohen κ coefficient. Survival data were analyzed using Kaplan-Meier curves and adjusted Cox regression analyses. RESULTS: Among 498 CHF inpatients, 84 (16.9%) died during the 18-month follow-up. Malnutrition prevalence was 47.2% and 50.4% based on the GLIM criteria and MNA, respectively (κ = 0.68; P < 0.001). Malnutrition was independently associated with a higher risk of all-cause mortality (GLIM criteria: hazard ratio, 2.16 [95% confidence interval (CI), 1.13-4.13]; MNA: hazard ratio, 4.28 [95% CI, 1.98-9.22]). Low body mass index was the strongest predictor of all-cause mortality in multivariable analysis (hazard ratio, 5.14; 95% CI, 3.19-8.27). CONCLUSION: The GLIM criteria showed strong consistency with MNA and effectively predicted all-cause mortality in CHF patients within 18 months.