Subjective Global Assessment in the Clinical Setting

Abstract

Background: Our goal was nutrition assessment in hospitalized patients of an internal medicine service. Methods: Ours was a longitudinal, prospective, and observational study. Four hundred twelve patients participated in this study using the Subjective Global Assessment (SGA). We used χ² for univariate and logistic regression. Results: Of 412 patients, 47.6% presented with malnutrition: 38.8% with moderate malnutrition (group B), and 8.58% with severe malnutrition (group C). Malnutrition was related to male patients older than 65 years, oncologic and infectious diseases, and length of hospitalization. Conclusions: Malnutrition incidence in an internal medical service is high. There is remarkable lack of interest in hospitalized patients' nutrition state. Results show similarities to other studies from Latin America.

This is a longitudinal, prospective, and observational study using the Subjective Global Assessment (SGA) to assess nutrition in hospitalized patients of an internal medicine service. The authors concluded that malnutrition incidence in an internal medical service is high.

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References

Chandra RK, Imbach A, Moore C, Skelton D, Woolcott D. Nutrition of the elderly. CMAJ. 1991 ;145:1475– 1487.

McWhirter JP, Pennington CR. Incidence and recognition of malnutrition in hospital. BMJ. 1994 ;308:945– 948.

Levine GM, Goldstein M, Robinson G. Impact of nutritional status on DRG length of stay. JPEN J Parenter Enteral Nutr. 1987 ;11:49– 51.

Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients.Nutrition. 2001;17:573– 580.

Kehr J, Aguayo B. Chilean survey of hospital nutrition status [abstract]. JPEN J Parenter Enteral Nutr. 2000 ;24: S14. Abstract P0008.

Wyszynski DF, Perman M, Crivelli A. Prevalence of hospital malnutrition in Argentina: preliminary results of a populationbased study.Nutrition. 2003;19:115– 119.

Detsky AS, Baker JP, Mendelson RA, Wolman SL, Wesson DE, Jeejeebhoy KN. Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: methodology and comparisons. JPEN J Parenter Enteral Nutr. 1984;8:153– 159.

Tibbitts C. First World Assembly on Aging termed long-range success. Aging. 1983 ;Mar–Apr(337):2– 5.

United Nations. Report of the Second World Assembly on Aging. United Nations; April 8–12,2002 ; Madrid, Spain.

10.

Tucker HN, Miguel SG. Cost containment through nutrition intervention. Nutr Rev. 1996 ;54:111– 121.

11.

Allison SP. Malnutrition, disease, and outcome.Nutrition. 2000;16:590– 593.

12.

Detsky AS, McLaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11:8– 13.

13.

Jeejeebhoy KN. Nutritional assessment. Gastroenterol Clin North Am. 1998;27:347– 369.

14.

Fiaccadori E, Lombardi M, Leonardi S, Rotelli CF, Tortorella G, Borghetti A. Prevalence and clinical outcome associated with preexisting malnutrition in acute renal failure: a prospective cohort study. J Am Soc Nephrol. 1999;10:581– 593.

15.

Jelliffe DB. The assessment of the nutritional status of the community (with special reference to field surveys in developing regions of the world). Monogr Ser World Health Organ. 1966 ;53:3– 271.

16.

Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981 ;34:2540– 2545.

17.

Thuluvath PJ, Triger DR. How valid are our reference standards of nutrition? Nutrition. 1995 ;11:731– 733.

18.

Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003 ;22:235– 239.

19.

Putwatana P, Reodecha P, Sirapo-Ngam Y, Lertsithichai P, Sumboonnanonda K. Nutrition screening tools and the prediction of postoperative infectious and wound complications: comparison of methods in presence of risk adjustment. Nutrition. 2005 ;21:691– 697.

20.

Nursal TZ, Noyan T, Atalay BG, Koz N, Karakayali H. Simple two-part tool for screening of malnutrition. Nutrition. 2005 ;21:659– 665.

21.

Weekes CE, Elia M, Emery PW. The development, validation and reliability of a nutrition screening tool based on the recommendations of the British Association for Parenteral and Enteral Nutrition (BAPEN). Clin Nutr. 2004;23:1104– 1112.

22.

Ferguson M, Capra S, Bauer J, Banks M. Development of a valid and reliable malnutrition screening tool for adult acute hospital patients.Nutrition. 1999;15:458– 464.

23.

Pablo AM, Izaga MA, Alday LA. Assessment of nutritional status on hospital admission: nutritional scores. Eur J Clin Nutr. 2003 ;57:824– 831.

24.

Rossi A, Rucci P, Mauri M, et al, for the EQUIP Group. Validity and reliability of the Italian version of the Quality of Life, Enjoyment and Satisfaction Questionnaire. Qual Life Res. 2005 ;14:2323– 2328.

25.

Waitzberg DL, Correia MI. Nutritional assessment in the hospitalized patient. Curr Opin Clin Nutr Metab Care. 2003 ;6:531– 538.

26.

Persson MD, Brismar KE, Katzarski KS, Nordenstrom J, Cederholm TE. Nutritional status using mini nutritional assessment and subjective global assessment to predict mortality in geriatric patients. J Am Geriatr Soc. 2002;50:1996– 2002.

27.

Heimburger DC. Physician-nutrition-specialist track: if we build it, will they come? Intersociety Professional Nutrition Education Consortium.Am J Clin. Nutr. 2000;71:1048– 1053.

28.

Ockenga J, Freudenreich M, Zakonsky R, Norman K, Pirlich M, Lochs H. Nutritional assessment and management in hospitalised patients: implication for DRG-based reimbursement and health care quality. Clin Nutr. 2005 ;24:913– 919.