Subjective global assessment is not sufficient to screen patients with defective hepatic metabolism.
OBJECTIVE
Subjective global assessment (SGA) is useful for screening malnourished patients with several diseases, although it has been indicated to underestimate nutritional status for patients with liver disease. Accordingly, the aim of this study was to examine the usefulness of SGA as a nutritional screening tool for patients with liver disease, compared to patients with gastroenterological disease, without bias of personal ability and experience.


METHODS
SGA was performed on 129 of hospitalized patients (86 with liver disease and 43 with gastroenterological disease). Nutritional status was categorized as well-nourished or malnourished status, based on nutritional indicators from laboratory data.


RESULTS
The SGA screening ratio (sensitivity) for malnourished patients with liver disease was significantly lower than gastroenterological disease, while specificity or efficiency was not significantly different. In nutritional indicators from laboratory data, the difference between SGA-positive and SGA-negative patients with liver disease was significant but not so remarkable compared with the difference between those with other diseases. The positive number of SGA components per patient for the liver disease group was significantly less than gastroenterological disease group.


CONCLUSIONS
SGA for patients with liver diseases was not sufficient as a nutritional screening tool because malnutrition induced by defective hepatic metabolism was not characterized fully.
Taniguchi
Eitaro
E
Division of Gastroenterology, Department of Medicine, Kurume, Japan. eitaro@med.kurume-u.ac.jp
Kawaguchi
Takumi
T
Itou
Minoru
M
Oriishi
Tetsuharu
T
Ibi
Ryoko
R
Torii
Mari
M
Yoshida
Kiyomi
K
Adachi
Yuko
Y
Otsuka
Momoka
M
Uchida
Yuuki
Y
Tanaka
Suiko
S
Takakura
Machiko
M
Sata
Michio
M
D000368:Aged; D005260:Female; D005759:Gastroenteritis / Q000150:complications* / Q000175:diagnosis; D006760:Hospitalization; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000175:diagnosis; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D008403:Mass Screening / Q000379:methods; D008659:Metabolic Diseases / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012680:Sensitivity and Specificity