title: Subjective global assessment is not sufficient to screen patients with defective hepatic metabolism.
abstract: 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.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume, Japan. eitaro@med.kurume-u.ac.jp
authors.forename: Eitaro
authors.initials: E
authors.lastname: Taniguchi
authors.forename: Takumi
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Minoru
authors.initials: M
authors.lastname: Itou
authors.forename: Tetsuharu
authors.initials: T
authors.lastname: Oriishi
authors.forename: Ryoko
authors.initials: R
authors.lastname: Ibi
authors.forename: Mari
authors.initials: M
authors.lastname: Torii
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yuko
authors.initials: Y
authors.lastname: Adachi
authors.forename: Momoka
authors.initials: M
authors.lastname: Otsuka
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Uchida
authors.forename: Suiko
authors.initials: S
authors.lastname: Tanaka
authors.forename: Machiko
authors.initials: M
authors.lastname: Takakura
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
mesh_terms: 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