Nutritional status of patients with advanced cancer: the value of using the subjective global assessment of nutritional status as a screening tool

Abstract

In patients suffering from advanced neoplastic disease, malnutrition is a common complication affecting both the survival and quality of life. In order to monitor early dietary interventions, an assessment of patients' nutritional status is essential. We assessed the nutritional status of 46 patients using two different methods: 1) an objective method of nutritional assessment and 2) the subjective global assessment (SGA) technique. It was found that 28 patients were characterized as malnourished by means of the objective method and 30 patients according to the SGA. The correlation of the results of the assessments between the two methods was high and a validation test of the SGA gave a sensitivity of 96% and specificity of 83%. The most frequent symptoms affecting food intake were anorexia, early satiety, dry mouth, pain and nausea. The results show that the SGA represents an easy method for assessment of the nutritional status in such cancer patients and that it can therefore be used as a screening tool. The high incidence of malnutrition in this group of patients, and their rare use of nutrient supplements, both indicate the importance of early nutritional assessment, and nutritional intervention when appropriate.

Prognostic significance of Subjective Global Assessment (SGA) in advanced colorectal cancer

“…After evaluation, patients are categorized into three distinct classes of nutritional status; well nourished (SGA A), moderately malnourished (SGA B) and severely malnourished (SGA C). The SGA has been validated in a number of diverse patient populations including cancer patients (Enia et al, 1993;Ek et al, 1996;Jones et al, 1997;Duerksen et al, 2000;Sacks et al, 2000;Thoresen et al, 2002). It has also been correlated with a number of objective nutritional assessment indicators, morbidity, mortality, and quality of life (QoL) measures (Detsky et al, 1987;Hirsch et al, 1991;Hasse et al, 1993;Ferguson et al, 1999a, b;Persson et al, 1999;Bauer et al, 2002).…”

Evaluation of change in dietitians’ perceived comprehensibility and difficulty of the Patient‐Generated Subjective Global Assessment (PG‐SGA) after a single training in the use of the instrument

“…(2,3) The PG-SGA includes a patient-generated component and a professional component, thus providing cumulative insight from both perspectives with respect to the nutritional status of the patient. The PG-SGA was first validated in the oncology setting (3)(4)(5)(6) and has subsequently been validated in other settings, such as nephrology and geriatric settings (7,8) .…”

Relación entre estado nutricional y evolución postoperatoria, en cirugía oncológica digestiva

“…Se clasificó como cirugías digestivas altas (n = 63) a las resecciones de esófago, estómago, intestino delgado, páncreas, hepático-biliar y como cirugías digestivas bajas (n = 66) a las resecciones de recto y colon (Tabla 2). Además, 32 pacientes fueron tratados con RT y/o QT neoadyuvante durante los meses previos, la mayor parte de éstos 24 No se observaron diferencias estadísticamente significativas en las variables nutricionales ni en la funcionalidad según el estadío tumoral. Los pacientes en etapas más avanzadas tenían PCR significativamente más altas, pero la mayor parte de los valores se encontraron dentro de rangos normales (Tabla 4).…”

“…Las Guías Clínicas de la Sociedad Europea de Nutrición Clínica y Metabolismo (ESPEN) recomiendan el Nutritional Risk Sreening (NRS 2002), para evaluación nutricional de pacientes hospitalizados, sin embargo, éste aún no ha sido validado en cohortes de pacientes con enfermedad neoplásica avanzada. Tanto la evaluación global subjetiva (EGS) como la EGS generada por el paciente (EGS GP) 22 no incluyen datos objetivos y cuantificables, pero son herramientas válidas en la evaluación de los pacientes con cán-cer [23][24][25][26][27][28] y se correlacionan bien con los métodos clásicos, constituyendo excelentes indicadores de pronóstico 29 .…”