SGA and measures for muscle mass and strength in surgical Vietnamese patients.
OBJECTIVE
This study compared the outcome of the Subjective Global Assessment (SGA) in preoperative surgical patients with objective measurements of muscle mass and strength and with biochemical data. A secondary aim was to test the influence of inflammatory activity on muscle strength.


METHODS
Two hundred seventy-four consecutive patients who were admitted for elective major abdominal surgery were assessed using the SGA, anthropometry, muscle strength, and laboratory measurements (hemoglobin, protein, albumin, C-reactive protein, and lymphocytes). Normal values for midarm muscle circumference (MAMC) and handgrip strength were obtained in a healthy control group. For all other variables, normal values available for the Vietnamese population were used.


RESULTS
Of 274 patients (151 men, 123 women) assessed, 61 (22.3%) were classified as SGA class A (well nourished), 97 patients (35.4%) as class B (moderately malnourished), and 116 patients (42.3%) as class C (severely malnourished). There were significant differences in age, body weight, percentage of weight loss, triceps skinfold thickness, MAMC, and serum albumin across the three SGA classes. Almost all patients rated class A had normal MAMC and handgrip strength. However, a large proportion of patients rated as B or C also had normal MAMC and handgrip strength (38% of men, 50% of women). Handgrip strength per square meter correlated with serum albumin (r = 0.278, P < 0.001) and this correlation persisted when handgrip strength was controlled for MAMC (r = 0.296, P < 0.001 in men; r = 0.237, P < 0.01 in women).


CONCLUSIONS
The SGA correctly identifies patients with normal muscle mass and strength but a substantial number of patients rated SGA B or C have normal muscle mass and strength. Muscle strength is not only positively associated with muscle mass but also negatively with inflammatory activity.
Pham
Nang V
NV
Department of Surgery, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
Cox-Reijven
Petronella L M
PL
Wodzig
Will K W H
WK
Greve
Jan W
JW
Soeters
Peter B
PB
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D018737:Hand Strength; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D015596:Nutrition Assessment; D009752:Nutritional Status; D011300:Preoperative Care; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D012737:Sex Factors; D012885:Skinfold Thickness; D014744:Vietnam
D012709:Serum Albumin; D002097:C-Reactive Protein