What is subjective global assessment of nutritional status?

TLDR

Subjective global assessment (SGA) is a clinical technique that evaluates nutritional status using history and physical examination features. The study aimed to assess how individual clinical variables taught to clinicians influence their SGA ratings. The authors applied SGA to 202 hospitalized patients before gastrointestinal surgery to evaluate its use. Nearly all clinical variables were significantly associated with SGA class, with loss of subcutaneous tissue, muscle wasting, and weight loss being the strongest predictors; interobserver agreement was high (kappa = 0.78), confirming that SGA is reproducible and easy to teach to clinicians.

Abstract

Presented and described in detail is a clinical technique called subjective global assessment (SGA), which assesses nutritional status based on features of the history and physical examination. Illustrative cases are presented. To clarify further the nature of the SGA, the method was applied before gastrointestinal surgery to 202 hospitalized patients. The primary aim of the study was to determine the extent to which our clinician's SGA ratings were influenced by the individual clinical variables on which the clinicians were taught to base their assessments. Virtually all of these variables were significantly related to SGA class. Multivariate analysis showed that ratings were most affected by loss of subcutaneous tissue, muscle wasting, and weight loss. A high degree of interobserver agreement was found (kappa = 0.78, 95% confidence interval 0.624 to 0.944, p less than 0.001). We conclude that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible.