Body mass index adjusted calf circumference as phenotypic criterion to diagnose malnutrition in cardiac patients admitted in intensive care unit

Introduction: Early screening malnutrition risk at hospital admission is crucial. However, the aim of the present study is to assess Body Mass Index (BMI) adjusted calf circumference (CC) as GLIM (Global Leadership Initiative on Malnutrition) phenotypic criterion to diagnose malnutrition in cardiac patients admitted to an intensive care unit due to lack of reports on it. Materials and Methods: Cross-sectional, descriptive study approaching cardiac patients admitted to an intensive care unit (ICU). Age, BMI (kg/m2) and CC (cm) were measured. CC was adjusted based on BMI categories. Nutritional Risk Screening (NRS 2002) and GLIM methods were used to assess malnutrition risk and diagnose, respectively. Statistical analysis included descriptive techniques.  Results: Thirty-six patients were assessed, 22 of them belonged to the male sex and 14, to the female sex. Most patients were elderly (n=22, 61.11%), recorded normal BMI weight (n=15, 41.66%), CC below the recommended cut-off point (n=19, 52.77%). BMI-adjusted CC was below the recommended cut-off point - males (n=12, 54.54%) and females (n=9, 64.28%). NRS 2002 ≥ 3 points (n=36, 4.05 ± 1.12). Patients scoring ≥ 3 were assessed based on GLIM criteria. GLIM: n=9 (25%) showed malnutrition, when BMI was used as a phenotypic criterion. Malnutrition was observed in most cases (n=19, 52.77%) when CC was the criterion. BMI-adjusted CC criterion resulted in malnutrition in 21 (58.33%) assessed patients (male, n=12, 54.54%; female, n=9, 64.28%). APACHE II score was ≥ 10 (n=36) and the mortality risk reached 55.50 ± 21.00% in the assessed patients. Conclusions: All patients showed nutritional risk (NRS 2002). Malnutrition prevalence varied when BMI, calf circumference (CC) and BMI-adjusted CC were used as  phenotypic criterion through GLIM diagnosing; it was higher in case of BMI-adjusted CC. Similarly, BMI-adjusted CC allowed diagnosing malnutrition through the GLIM method applied in overweight patients.