The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy

Abstract

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.

A Prospective Investigation of Swallowing, Nutrition, and Patient-rated Functional Impact Following Altered Fractionation Radiotherapy with Concomitant Boost for Oropharyngeal Cancer

“…Equally though, a more prompt oropharyngeal transit may reflect pain, hypersensitivity and phagophobia 61 to swallowing caused by acute toxicity may have led to reduced oral intake which influenced weight and overall nutrition status. In the current cohort, the PG-SGA scores paralleled weight loss, which is similar to that of previous studies 43 , however peak difficulties in meeting nutritional requirements usually occurred prior to the 4-6 week post-treatment time point.…”

“…This assessment tool has been validated in the head and neck cancer population and is used extensively in clinical practice and clinical trials of nutrition intervention regimens 42,43 . The PG-SGA comprises a patient completed section and a physical examination completed by a dietitian.…”

“…The patient was rated globally as "well nourished" (PG-SGA A), "moderately malnourished" or "suspected of being malnourished" (PG-SGA B), or "severely malnourished" (PG-SGA C). A numerical PG-SGA score was also calculated (range = 0 -35) where a higher score is reflective of greater nutritional compromise, and scores greater than 9 are considered indicative of a critical need for nutritional intervention or symptom management 39,43 .…”

Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area

“…Patient-Generated-Subjective Global Assessment score, correlated with objective nutrition parameters (% weight loss, BMI), QoL, morbidity (survival, length of stay), has a high degree of inter-rater reproducibility and a high sensitivity and specificity when compared with other validated nutritional assessment tools Isenring et al, 2002). Each subject was classified as either well nourished (SGA A), moderately nourished or suspected of being malnourished (SGA B), or severely malnourished (SGA C), and in addition, a total PG-SGA score was calculated.…”

Malnutrition among gynaecological cancer patients

“…The patient-generated SGA (PG-SGA) is a further modification of the SGA and has been specifically developed for patients with cancer (Ottery, 1996). The PG-SGA has been used for nutritional assessment in patients with various types of cancer such as cancer of the oesophagus, stomach, pancreas, lung, colorectum, breast and head and neck (Bauer et al, 2002;Persson et al, 2002;Isenring et al, 2003;Ravasco et al, 2003Ravasco et al, , 2005Bauer and Capra, 2005;Desbrow et al, 2005;Horsley et al, 2005;Segura et al, 2005). Bauer et al (2002) compared the scored PG-SGA with the SGA for patients with cancer and suggested the PG-SGA be used for further studies to detect malnutrition in cancer populations.…”