title: Does the Subjective Global Assessment Predict Outcome in Critically Ill Medical Patients?
abstract: BACKGROUND
  The Subjective Global Assessment (SGA) is a validated nutrition assessment tool that is not commonly used to evaluate the nutritional status of patients admitted to the intensive care unit (ICU).
  
  
  OBJECTIVE
  The aims of this study were to determine the prevalence of malnutrition in critically ill medical patients using the SGA and to determine whether the SGA was predictive of patient outcome.
  
  
  METHODS
  A retrospective chart review was performed on 57 consecutive patients admitted to a single tertiary care medical ICU and requiring mechanical ventilation over a 6-month time period. All SGA assessments were performed by a single dietitian trained in this assessment technique. Multiple factors including patient demographics, severity of illness, length of mechanical ventilation, length of ICU stay, and mortality were abstracted from the charts.
  
  
  RESULTS
  The prevalence of malnutrition on admission as assessed by the SGA was 35%. Severity of illness as determined by Acute Physiology and Chronic Health Evaluation II (APACHE II) score was not different between the SGA groups. Mortality rates were significantly higher in the moderately (45.5%) and severely malnourished (55.6%) groups than in the well-nourished group (10.8%; P = .004).
  
  
  CONCLUSIONS
  Malnutrition on admission is common in critically ill medical patients. Malnutrition, as assessed by SGA at admission to ICU, is associated with increased mortality and thus can serve as a valuable prognostic tool in the assessment of critically ill patients. Given that that the SGA is a simple bedside assessment, it should be considered for routine use in assessing critically ill patients.
authors.affiliation: Department of Nutrition and Food Services, Health Science Centre, Winnipeg Manitoba, Canada.
authors.forename: Savita
authors.initials: S
authors.lastname: Bector
authors.affiliation: Department of Nutrition and Food Services, Health Science Centre, Winnipeg Manitoba, Canada.
authors.forename: Kathy
authors.initials: K
authors.lastname: Vagianos
authors.affiliation: Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Miyoung
authors.initials: M
authors.lastname: Suh
authors.affiliation: Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada duerksn@cc.umanitoba.ca.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Duerksen
mesh_terms: D015992:Body Mass Index; D016638:Critical Illness / Q000401:mortality* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000401:mortality; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies
keywords: Subjective Global Assessment; critically ill; intensive care unit; malnutrition; mortality; nutrition assessment