Objective: To evaluate the use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Design: An observational study assessing the nutritional status of patients with cancer. Setting: Oncology ward of a private tertiary Australian hospital. Subjects: Seventy-one cancer patients aged 18 -92 y. Intervention: Scored PG-SGA questionnaire, comparison of scored PG-SGA with subjective global assessment (SGA), sensitivity, specificity. Results: Some 24% (17) of 71 patients were well nourished, 59% (42) of patients were moderately or suspected of being malnourished and 17% (12) of patients were severely malnourished according to subjective global assessment (SGA). The PG-SGA score had a sensitivity of 98% and a specificity of 82% at predicting SGA classification. There was a significant difference in the median PG-SGA scores for each of the SGA classifications (P < 0.001), with the severely malnourished patients having the highest scores. Re-admission within 30 days of discharge was significantly different between SGA groups (P ¼ 0.037). The mortality rate within 30 days of discharge was not significantly different between SGA groups (P ¼ 0.305). The median length of stay of well nourished patients (SGA A) was significantly lower than that of the malnourished (SGA B þ C) patients (P ¼ 0.024). Conclusion:The scored PG-SGA is an easy to use nutrition assessment tool that allows quick identification and prioritisation of malnutrition in hospitalised patients with cancer.

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Malnutrition occurs frequently in patients with cancer of the gastrointestinal (GI) or head and neck area and can lead to negative outcomes. The aim of this study is to determine the impact of early and intensive nutrition intervention (NI) on body weight, body composition, nutritional status, global quality of life (QoL) and physical function compared to usual practice in oncology outpatients receiving radiotherapy to the GI or head and neck area. Outpatients commencing at least 20 fractions of radiotherapy to the GI or head and neck area were randomised to receive intensive, individualised nutrition counselling by a dietitian using a standard protocol and oral supplements if required, or the usual practice of the centre (general advice and nutrition booklet). Outcome parameters were measured at baseline and 4, 8 and 12 weeks after commencing radiotherapy using valid and reliable tools. A total of 60 patients (51M : 9F; mean age 61.9714.0 years) were randomised to receive either NI (n ¼ 29) or usual care (UC) (n ¼ 31). The NI group had statistically smaller deteriorations in weight (Po0.001), nutritional status (P ¼ 0.020) and global QoL (P ¼ 0.009) compared with those receiving UC. Clinically, but not statistically significant differences in fat-free mass were observed between the groups (P ¼ 0.195). Early and intensive NI appears beneficial in terms of minimising weight loss, deterioration in nutritional status, global QoL and physical function in oncology outpatients receiving radiotherapy to the GI or head and neck area. Weight maintenance in this population leads to beneficial outcomes and suggests that this, rather than weight gain, may be a more appropriate aim of NI.

Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the nutrition care day survey 2010 Ekta AgarwalThe University of Queensland Maree Ferguson Princess Alexandra Hospital Merrilyn Banks Royal Brisbane & Womens Hospital Marijka Batterham University of Wollongong Judith BauerThe University of Queensland Recommended Citation Agarwal, E., Ferguson, M., Banks, M., Batterham, M., Bauer, J., Capra, S., & Isenring, E. (2013). Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the nutrition care day survey 2010. Retrieved from http://dx

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Intensive nutrition intervention following the ADA MNT protocol results in improved dietary intake compared with standard practice and seems to beneficially impact nutrition-related outcomes previously observed in oncology outpatients receiving radiotherapy. The ADA MNT protocol for radiation oncology is a useful guide to the level of nutrition support required.

Objective: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL). Design: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area. Setting: Australian radiation oncology facilities. Subjects: Sixty cancer patients aged 24-85 y. Intervention: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3). Results: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r ¼ 7 0.66, P < 0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P < 0.001) and SGA (P < 0.001); and a decrease in global QoL (P < 0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P < 0.001) and change in global QoL (P ¼ 0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r ¼ 7 0.55, P < 0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P ¼ 0.001). Conclusion:The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.

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