Validez y confiabilidad de los criterios de desnutrición GLIM en cirugía cardíaca
DOI:
https://doi.org/10.15649/cuidarte.5046Palabras clave:
Desnutrición Proteico-Calórica, Procedimientos Quirúrgicos Cardíacos, Estudio de Validación, Recuperación Mejorada Después de Cirugía, Reproducibilidad de los ResultadosResumen
Highlights
- Más de la mitad de los pacientes candidatos a cirugía cardiaca presentaban desnutrición al momento de la valoración preoperatoria.
- La masa muscular mostró una asociación inversa con los días de estancia hospitalaria, subrayando su relevancia clínica en pacientes quirúrgicos.
- Los criterios Global Leadership Initiative on Malnutrition (GLIM) evidenciaron un desempeño diagnóstico adecuado y constituyen una alternativa confiable para la identificación de la desnutrición.
- La desnutrición definida por GLIM duplicó el riesgo de readmisión hospitalaria por complicaciones quirúrgicas, confirmando su valor pronóstico.
Introducción: La desnutrición es frecuente en pacientes de cirugía cardiaca y se asocia con desenlaces clínicos adversos. Sin embargo, no existen criterios validados para el diagnóstico nutricional de esta población. Objetivo: Determinar la validez de criterio y la confiabilidad interevaluador de los criterios GLIM para el diagnóstico de desnutrición y la predicción de desenlaces en cirugía cardiaca. Materiales y Métodos: Estudio de validación en adultos programados para cirugía cardiaca. La validez concurrente se estableció con la Valoración Global Subjetiva y la validez predictiva con el reingreso hospitalario a 30 días. La confiabilidad se evaluó con dos profesionales. Se siguieron los análisis y puntos de corte de la guía de validación de GLIM. El procesamiento estadístico se efectuó en R y Jamovi. Resultados: Se demostró la confiabilidad interevaluador de GLIM, con concordancia casi perfecta (Kappa 0,94, IC 95% 0,88-0,99, p<0,001), y su validez predictiva para reingreso hospitalario (RRa 2,59, IC 95% 1,09 – 7,02, p 0,04). No se alcanzaron los umbrales de validación concurrente (sensibilidad 88,0%, IC 95% 68,8-97,5%; especificidad 76,9%, IC 95% 56,4-91,0%). Discusión: La falta de validación concurrente podría explicarse por diferencias en la estimación de la masa muscular entre métodos diagnósticos. Los resultados coinciden con literatura previa que respalda la confiabilidad y capacidad predictiva de GLIM. Conclusión: Los criterios GLIM son confiables y predicen desenlaces relevantes en cirugía cardiaca, lo que respalda su utilidad para el diagnóstico nutricional y su potencial aplicación en la identificación temprana de pacientes candidatos a intervenciones de optimización preoperatoria.
Como citar este artículo: Londoño-Pereira Mateo, Agudelo-Cifuentes Maite Catalina, Múnera Nora, Paredes Sara, Londoño Maritza, Yepes Mónica. Validez y confiabilidad de los criterios de desnutrición GLIM en cirugía cardíaca. Revista Cuidarte. 2026;17(2):e5046. https://doi.org/10.15649/cuidarte.5046
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