Seven-Point Subjective Global Assessment Is More Time Sensitive Than Conventional Subjective Global Assessment in Detecting Nutrition Changes

Abstract

Background: It is important for nutrition intervention in malnourished patients to be guided by accurate evaluation and detection of small changes in the patient’s nutrition status over time. However, the current Subjective Global Assessment (SGA) is not able to detect changes in a short period. The aim of the study was to determine whether the 7-point SGA is more time sensitive to nutrition changes than the conventional SGA. Methods: In this prospective study, 67 adult inpatients assessed as malnourished using both the 7-point SGA and conventional SGA were recruited. Each patient received nutrition intervention and was followed up after discharge. Patients were reassessed using both tools at 1, 3, and 5 months from baseline assessment. Results: It took significantly shorter time to see a 1-point change using the 7-point SGA compared with the conventional SGA (median: 1 month vs 3 months, P = .002). The likelihood of at least a 1-point change is 6.74 times greater in the 7-point SGA compared with the conventional SGA after controlling for age, sex, and medical specialties (odds ratio, 6.74; 95% confidence interval, 2.88–15.80; P < .001). Fifty-six percent of patients who had no change in SGA score had changes detected using the 7-point SGA. The level of agreement was 100% (κ = 1, P < .001) between the 7-point SGA and 3-point SGA and 83% (κ = 0.726, P < .001) between 2 blinded assessors for the 7-point SGA. Conclusion: The 7-point SGA is more time sensitive in its response to nutrition changes than the conventional SGA. It can be used to guide nutrition intervention for patients.