Malnutrition according to the Global Leadership Initiative on Malnutrition criteria is associated with in-hospital mortality and prolonged length of stay in patients with cirrhosis

• There is scarce evidence pertaining to the validity of GLIM criteria in the context of cirrhosis. • Malnutrition according to the GLIM criteria was considerably prevalent among hospitalized patients with cirrhosis. • Malnutrition was associated with around 2 times greater probability of in-hospital mortality and prolonged LOS. • All practical indicators incorporated into the GLIM diagnostic framework showed independent significance in relation to dismal outcomes. • The GLIM criteria may be implemented and disseminated during daily practice taking consideration of predictive validity. Malnutrition is prevalent and negatively impacts patients with cirrhosis, but lacking generally accepted consensus pertaining to its diagnosis. More recently, a framework designated as the Global Leadership Initiative on Malnutrition (GLIM) has been proposed for diagnosing malnutrition and there is scant evidence regarding its validity. We aimed to investigate associations of malnutrition according to the GLIM criteria and its individual indicator with in-hospital adverse outcomes. Prospective observational study enrolling consecutively hospitalized cirrhosis. The malnutrition diagnosis was built on stepwise GLIM process with initial screening followed by fulfillment of at least one phenotypic criterion and one etiologic criterion. The patients were followed up for a combined endpoint of in-hospital mortality and prolonged length of stay (LOS). Covariates compromise malnutrition according to the GLIM criteria and its indicators in separation. Logistic regression analyses were implemented for determining predictive validity. Totally, 387 cirrhotic patients were assessed. Malnutrition was diagnosed in 28.7% of patients according to the GLIM criteria, and increased the risk of in-hospital mortality/prolonged LOS by 2.166 times and 1.767 times, adjusting for age, sex, biochemical parameters and clinical scores of disease severity. Looking into separate criterion, all constituents were independently associated with in-hospital adverse outcomes, adjusting for model for end-stage liver disease-sodium score. Malnutrition according to the GLIM criteria was considerably prevalent among hospitalized patients with cirrhosis and associated with around 2 times greater probability of in-hospital mortality and prolonged LOS. This diagnostic instrument may be implemented and disseminated during daily practice considering well predictive validity.