SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1676201
Association between malnutrition diagnosed by different screening and asscessment tools and clinical outcomes: an umbrella review
Provisionally accepted
Zhinan Li1Yueying Lin1Yanmei Shi1Ting Yang1Liya An1Yuxing Qi1Pengcheng Zhang1Xingzong Huang1Xianming Su1Yinlong Deng1Jian Hu1Guobin Liu1
Dali Sun1,2*- 1Second Affiliated Hospital of Kunming Medical University / Second Faculty of Clinical Medicine, Kunming Medical University, kunmming, China
- 2The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Background: Malnutrition can lead to adverse clinical outcomes in hospitalized patients, timely and accurate diagnosis of malnutrition is crucial for initiating early nutritional support programs. To assess the correlation between malnutrition diagnosed by different malnutrition diagnostic tools and patients' clinical outcomes. Methods: Meta-analyses of the associations between malnutrition and patients' clinical outcomes were screened and included by searching databases. For each association, this study used fixed and random effects models, calculated 95% CI (confidence intervals) and 95% PI (prediction intervals), and assessed heterogeneity, evidence of small-study effects, and excess significance bias. Results: A total of 138 meta-analyses were included in this study, and 407 associations were evaluated. For oncology patients, malnutrition diagnosed by 8 tools was associated with oncological survival, with 3 evidence scores of PNI (prognostic nutritional index), GNRI (geriatric nutritional risk index), and CONUT (controlling nutritional status) being highly recommended (Class II). For nontumor patients, malnutrition diagnosed by 9 tools was associated with poor clinical outcomes, with 4 tools with high evidence scores (Class II) of PNI, BMI (body mass index) <18.5 kg/m2, GNRI, and CONUT being highly recommended. Conclusions: This study demonstrated a significant correlation (Class II) between malnutrition diagnosed by four tools, the PNI, BMI <18.5 kg/m2, GNRI, and CONUT, and clinical outcomes, and the other tools need to be validated in future high-quality studies despite their correlation. Trial registration: The protocol for the study was registered on the International Prospective Register of Systematic Reviews, PROSPERO (CRD42024586175) on September 13, 2024.
Keywords: clinical outcomes, Malnutrition, Nutritional screening, Nutritional screening andassessment tools, Umbrella review
Received: 30 Jul 2025; Accepted: 24 Sep 2025.
Copyright: © 2025 Li, Lin, Shi, Yang, An, Qi, Zhang, Huang, Su, Deng, Hu, Liu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dali Sun, sundali2018@126.com
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