Clinical application of subjective global assessment in Chinese patients with gastrointestinal cancer.
OBJECTIVE
To investigate the role of subjective global assessment (SGA) in nutritional assessment and outcome prediction of Chinese patients with gastrointestinal cancer.


METHODS
A total of 751 patients diagnosed with gastrointestinal cancer between August 2004 and August 2006 were enrolled in this study. Within 72 h after admission, SGA, anthropometric parameters, and laboratory tests were used to assess the nutritional status of each patient. The outcome variables including hospital stay, complications, and in-hospital medical expenditure were also obtained.


RESULTS
Based on the results of SGA, 389 (51.8%), 332 (44.2%), and 30 (4.0%) patients were classified into well nourished group (SGA-A), mildly to moderately malnourished group (SGA-B), and severely malnourished group (SGA-C), respectively. The prevalence of malnutrition classified by SGA, triceps skinfold thickness (TSF), mid-upper arm muscle circumference (MAMC), albumin (ALB), prealbumin (PA), and body mass index (BMI) was 48.2%, 39.4%, 37.7%, 31.3%, 21.7%, and 9.6%, respectively. In addition, ANOVA tests revealed significant differences in body mass index (BMI), TSF, PA, and ALB of patients in different SGA groups. The more severely malnourished the patient was, the lower the levels of BMI, TSF, PA, and ALB were (P < 0.05). Chi2 tests showed a significant difference in SGA classification between patients receiving different types of treatment (surgery vs chemotherapy/radiotherapy). As the nutritional status classified by SGA deteriorated, the patients stayed longer in hospital and their medical expenditures increased significantly. Furthermore, multiple regression analysis showed that SGA and serum ALB could help predict the medical expenditures and hospital stay of patients undergoing surgery. The occurrence of complications increased in parallel with the increasing grade of SGA, and was the highest in the SGA-C group (23.3%) and the lowest in the SGA-A group (16.8%).


CONCLUSIONS
SGA is a reliable assessment tool and helps to predict the hospital stay and medical expenditures of Chinese surgical gastrointestinal cancer patients.
Wu
Bei-Wen
BW
Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Yin
Tao
T
Cao
Wei-Xin
WX
Gu
Zhi-Dong
ZD
Wang
Xiao-Jin
XJ
Yan
Min
M
Liu
Bing-Ya
BY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D044466:Asian People; D017281:Cost of Illness; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D016896:Treatment Outcome; D055815:Young Adult