title: Use of subjective global assessment to identify nutrition-associated complications and death in geriatric long-term care facility residents.
abstract: OBJECTIVE
  The primary objective of this study was to assess the use of Subjective Global Assessment to identify nutrition-associated complications and death in a geriatric population. A secondary objective was to evaluate the ability of Subjective Global Assessment to identify geriatric residents of long-term care facilities who were undernourished or at risk for developing undernutrition.
  
  
  METHODS
  Fifty-three consecutive residents who were > or = 65 years of age and had been residing in a long-term care facility for < 2 weeks were enrolled in the study. The Subjective Global Assessment Classification technique was performed according to the procedure outlined by Detsky and colleagues. Residents were classified as well-nourished (A), mild/moderately undernourished (B) or severely undernourished (C). In addition, a Subjective Global Assessment Composite Score was derived. Subjective Global Assessment measures were compared with two traditional objective measurements of nutritional status: serum albumin and serum total cholesterol. Outcome measurements of nutrition-associated complications were determined over a 3-month period by recording the incidence of major infections, decubitus ulcers, nutrition-related hospital readmissions, and mortality.
  
  
  RESULTS
  Sixteen residents (30.2%) were categorized as Subjective Global Assessment class A, 28 residents (52.8%) were class B, and 9 residents (17%) were class C. A significant association was found between nutritional status as determined by Subjective Global Assessment Composite Score and nutrition-associated complications (p<0.05). Subjective Global Assessment Classification was related to death (p<0.05) with severely undernourished residents having the highest mortality rate. Hypoalbuminemia only demonstrated a significant relationship with nutrition-associated complications (p<0.05), whereas hypocholesterolemia was associated with death (p<0.05).
  
  
  CONCLUSIONS
  Subjective Global Assessment of nutritional status appears to be a simple, noninvasive and cost-effective tool for assessing nutritional status of geriatric residents in long-term care facilities. This assessment tool is also beneficial for identifying patients with increased risk of nutrition-associated complications as well as death.
authors.affiliation: Department of Clinical Pharmacy,The University of Mississippi Jackson, USA. gsacks@pharmacy.umsmed.edu
authors.forename: G S
authors.initials: GS
authors.lastname: Sacks
authors.forename: K
authors.initials: K
authors.lastname: Dearman
authors.forename: W H
authors.initials: WH
authors.lastname: Replogle
authors.forename: V L
authors.initials: VL
authors.lastname: Cora
authors.forename: M
authors.initials: M
authors.lastname: Meeks
authors.forename: T
authors.initials: T
authors.lastname: Canada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008134:Long-Term Care; D008297:Male; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000145:classification / Q000150:complications / Q000401:mortality*; D009752:Nutritional Status; D012709:Serum Albumin / Q000032:analysis; D014481:United States / Q000453:epidemiology
chemical_list: D012709:Serum Albumin; D002784:Cholesterol