Presented and described in detail is a clinical technique called subjective global assessment (SGA), which assesses nutritional status based on features of the history and physical examination. Illustrative cases are presented. To clarify further the nature of the SGA, the method was applied before gastrointestinal surgery to 202 hospitalized patients. The primary aim of the study was to determine the extent to which our clinician's SGA ratings were influenced by the individual clinical variables on which the clinicians were taught to base their assessments. Virtually all of these variables were significantly related to SGA class. Multivariate analysis showed that ratings were most affected by loss of subcutaneous tissue, muscle wasting, and weight loss. A high degree of interobserver agreement was found (kappa = 0.78, 95% confidence interval 0.624 to 0.944, p less than 0.001). We conclude that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible.

http://www.nutricionclinica.sld.cu/Editoriales/DetskyASArticleOnSGA.pdf

What is subjective global assessment of nutritional status

https://espen.info/documents/Screening.pdf

ESPEN Guidelines for Nutrition Screening 2002

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ESPEN guidelines on nutrition in cancer patients

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Herein we describe a methodology which can be used to evaluate the predictive accuracy of nutritional assessment techniques. We use this methodology to compare seven techniques of nutritional assessment in terms of their ability to predict one nutrition associated hospital complication (infection) by dividing a sample of 59 surgical patients into high risk and low risk groups. One technique was subjective global assessment (SGA) of the patient's nutritional status on admission to hospital. Five techniques were single objective measurements (albumin, transferrin, delayed cutaneous hypersensitivity, anthropometry, and creatinine-height index). The 7th technique was the prognostic nutritional index. The best combination of sensitivity (0.82) and specificity (0.72) was found with SGA. The second best combination (0.88 and 0.45) was found by using either the prognostic nutritional index or creatinine-height index. We also found that combining the five objective measurements with SGA into a single index did not...

K.N. Jeejeebhoy

Papers

What is subjective global assessment of nutritional status

Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: methodology and comparisons.

Total parenteral nutrition at home for 23 months, without complication, and with good rehabilitation. A study of technical and metabolic features.

Microfilament dysfunction as a possible cause of intrahepatic cholestasis.

Breath pentane analysis as an index of lipid peroxidation: a functional test of vitamin E status.