title: Subjective global assessment of nutritional status in cardiac patients.
abstract: OBJECTIVE
  To analyze the performance of Subjective Global Assessment of Nutritional Status (SGA) in diagnosing malnutrition in patients with heart disease.
  
  
  METHODS
  One hundred and six hospitalized patients (53 with heart failure) completed an SGA questionnaire on their nutritional history (changes in body weight, dietary intake, gastrointestinal symptoms, functional capacity, and diagnosis) and underwent physical examination. Then, anthropometric measurements were obtained (body weight, mid-arm circumference, triceps skinfold thickness, and arm muscle circumference). Serum albumin, total lymphocyte count and anthropometric measurements were determined for the objective assessment of patients with congestive heart failure. An ROC curve was used to analyze sensitivity, specificity and accuracy of SGA compared to the objective assessment.
  
  
  RESULTS
  Patients' age was 57.7 +/- 15.7, and the majority was male (67.9%). The ROC curve showed score 16 as SGA cut-off point with the highest sensitivity (62.2%) and specificity (55.7%). The area under the curve was 0.601 (95% CI: 0.487-0.715). Anthropometric assessment showed malnutrition prevalence at 51.9% by SGA and 42.5% by, with accuracy of 65.3% in men and 44.1% in women. In patients with congestive heart failure, SGA assessed malnutrition prevalence was 60.4%, while objective assessment was 32.1% with accuracy of 67.6% in men and 31.3% in women.
  
  
  CONCLUSIONS
  SGA detected a greater number of malnourished patients than the objective evaluation. Its performance in identifying malnutrition was better in men. It also detected cardiac patients at nutritional risk.
authors.affiliation: Hospital Auxiliar de Cotoxó, Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil. aureaky@hcnet.usp.br
authors.forename: Aurea Kaoru
authors.initials: AK
authors.lastname: Yamauti
authors.forename: Marcelo Eidi
authors.initials: ME
authors.lastname: Ochiai
authors.forename: Paula Sofia
authors.initials: PS
authors.lastname: Bifulco
authors.forename: Moab Alves
authors.initials: MA
authors.lastname: de Araújo
authors.forename: Rosiris Roco
authors.initials: RR
authors.lastname: Alonso
authors.forename: Regina Helena Cunha
authors.initials: RH
authors.lastname: Ribeiro
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Pereira-Barretto
mesh_terms: D000886:Anthropometry; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires