scholarly journals Clinical assessment of nutritional status using the modified quantified subjective global assessment and anthropometric and biochemical parameters in patients undergoing hemodialysis in Macao

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110455
Author(s):  
Hongquan Peng ◽  
Chiwa Aoieong ◽  
Tou Tou ◽  
Tsungyang Tsai ◽  
Jianxun Wu

Objective Malnutrition is widespread among patients undergoing hemodialysis and is linked to high morbidity and mortality rates. We evaluated the nutritional status and malnutrition markers in patients undergoing hemodialysis in Macao. Methods We performed a cross-sectional analysis of 360 patients in a hemodialysis center. The modified quantitative subjective global assessment (MQSGA), anthropometric indices and related biochemical test data were used to evaluate nutritional status. Results The sample's mean age was 63.47 ± 13.95 years. There were 210 well-nourished (58.3%), 139 mild-to-moderately malnourished (38.6%) and 11 severely malnourished (3.1%) patients. Older patients had a higher incidence of severe malnutrition, but there were no significant differences between diabetic and non-diabetic patients. Mid-arm circumference (MAC); mid-arm muscle circumference; body mass index; triceps skin fold thickness; serum albumin, creatinine and urea; and hemoglobin were all valid for assessing nutritional status. MAC and the serum albumin and creatinine concentrations significantly negatively correlated with MQSGA. Conclusions Malnutrition is commonplace in patients undergoing hemodialysis in Macao, but their nutritional status is not affected by diabetes. Serum creatinine, serum albumin and MAC, and especially pre-dialysis creatinine concentration, represent effective, readily available, and easily remembered screening measures of nutritional status for patients undergoing maintenance dialysis.

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Patrícia Amaro Andrade ◽  
Carolina Araújo dos Santos ◽  
Heloísa Helena Firmino ◽  
Carla de Oliveira Barbosa Rosa

ABSTRACT Objective: To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). Methods: This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson’s χ2 and Spearman’s correlation were used to verify differences between the groups. Results: The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. Conclusion: Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.


2022 ◽  
Vol 71 (12) ◽  
pp. 2761-2765
Author(s):  
Lubna Ghazi ◽  
Murtaza Dhrolia ◽  
Aamna Hamid ◽  
Ruqaya Qureshi ◽  
Kiran Nasir ◽  
...  

Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64%).None of patient had severe malnourishment. Females were 2.6 times more prone for malnourishment (p value=0.009). More than 5- years on hemodialysis also increased the risk of malnourishment by 12.5 times (p value <0.001). Overweight patients had 85 % less chance of being malnourished as compare to patients with normal weight (p value=0.004). Conclusion: Malnutrition is quite common in hemodialysis patients, which necessitates its regular assessment and monitoring. There is a need to assess the reasons of more malnourishment in female as compared to male. Similarly, the longer duration (> 5 years) on hemodialysis also need attention for prevention and cure of malnourishment.  Continuous...


2015 ◽  
Vol 8 ◽  
pp. NMI.S27640 ◽  
Author(s):  
Arun Sedhain ◽  
Rajani Hada ◽  
Rajendra Kumar Agrawal ◽  
Gandhi R. Bhattarai ◽  
Anil Baral

Objective To assess the nutritional status of patients on maintenance hemodialysis by using modified quantitative subjective global assessment (MQSGA) and anthropometric measurements. Method We Conducted a cross sectional descriptive analytical study to assess the nutritional status of fifty four patients with chronic kidney disease undergoing maintenance hemodialysis by using MQSGA and different anthropometric and laboratory measurements like body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), triceps skin fold (TSF) and biceps skin fold (BSF), serum albumin, C-reactive protein (CRP) and lipid profile in a government tertiary hospital at Kathmandu, Nepal. Results Based on MQSGA criteria, 66.7% of the patients suffered from mild to moderate malnutrition and 33.3% were well nourished. None of the patients were severely malnourished. CRP was positive in 56.3% patients. Serum albumin, MAC and BMI were (mean + SD) 4.0 + 0.3 mg/dl, 22 + 2.6 cm and 19.6 ± 3.2 kg/m2 respectively. MQSGA showed negative correlation with MAC ( r = −0.563; P = < 0.001), BMI ( r = −0.448; P = < 0.001), MAMC ( r = −0.506; P = < .0001), TSF ( r = −0.483; P = < .0002), and BSF ( r = −0.508; P = < 0.0001). Negative correlation of MQSGA was also found with total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol without any statistical significance. Conclusion Mild to moderate malnutrition was found to be present in two thirds of the patients undergoing hemodialysis. Anthropometric measurements like BMI, MAC, MAMC, BSF and TSF were negatively correlated with MQSGA. Anthropometric and laboratory assessment tools could be used for nutritional assessment as they are relatively easier, cheaper and practical markers of nutritional status.


2020 ◽  
Vol 4 (2) ◽  
pp. 76
Author(s):  
Khoirul Anam ◽  
Takdir Tahir ◽  
Ilkafah Ilkafah

Background: Chemotherapy is highly recommended for cancer treatment, however can cause some side effects such as nausea and vomiting. This will affect food intake and nutritional status in cancer patients who undergo chemotherapy. Aim: To describe nutritional status based on anthropometry Body Mass Index (BMI), hemoglobin (Hb), Patient-Generated Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA) in cancer patients undergoing chemotherapy in RSUP. Dr. Wahidin sudirohusodo Makassar. Methode: This experiment uses a quantitative non-experimental research method with cross sectional approach on 1010 patients, nonprobability sampling with purposive sampling technique on 70 respondents, data collection with interview and observation techniques. Results: Nutritional status based on Body Mass Index (BMI) shows that 39 people (55.7%) had normal BMI values. About 37 people (52.9%) had good / normal nutritional status based on Patient-Generated Subjective Global Assessment (PG-SGA)  while Mini Nutritional Assessment (MNA) reveals 100% of respondents experienced nutritional status problems. Conclusion: Mini Nutritional Assessment (MNA) is the best tool to identify nutritional status of cancer patients that undergo chemotherapy since this instrument is very sensitive and practical. Patient-Generated Subjective Global Assessment (PG-SGA) is good to assess nutritional status in subject who have lost weight drastically and shows signs of subcutaneous fat loss and muscle mass loss. Keyword: Cancer, chemotherapy, body mass index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA).


2020 ◽  
Author(s):  
Atefe Kohansal ◽  
Zahra Sohrabi ◽  
Hanieh Mirzahosseini ◽  
Moein Naghibi ◽  
Morteza Zare ◽  
...  

Abstract Background: Protein-energy wasting (PEW) is prevalent among hemodialysis (HD) patients and is associated with poor outcomes. There are various methods for evaluating nutritional status in HD patients that each has its own advantages and disadvantages. We aimed at comparing the methods of normalized protein catabolic ratio (nPCR) and malnutrition universal screening tool (MUST) with subjective global assessment (SGA) in HD patients. Method: We examined 88 HD patients using SGA and MUST questionnaires, and also nPCR were calculated using predialysis and post-dialysis BUN, and Kt/v. Also, patients were assessed for PEW based on the Criteria of the International Society of Renal Nutrition and Metabolism. Methods’ specificity, sensitivity, and precision rates were assessed. Correlations between methods were analyzed using Pearson-correlation. Results: Based on the SGA, MUST, and nPCR methods, almost 41, 30, and 60 percent of patients had malnutrition, respectively. According to the criteria by International Society of Renal Nutrition and Metabolism, more than 90 percent of patients had PEW. SGA was positively and significantly associated with MUST (P≤0.001). Sensitivity for SGA, MUST, and nPCR methods were 100,100, 1.8 %, and their specificity were 98, 98, and 4 %, respectively and their precision rates were 99.7, 98.7, and 3%, respectively. Conclusion: From various methods of nutritional assessment (SGA, MUST, and nPCR), compared to SGA as the common method of nutrition assessment in hemodialysis patients, MUST had the nearest specificity, sensitivity, and precision rate compared to SGA and nPCR method had the lowest ones. nPCR seems to be a flawed marker of malnutrition and it should be more investigated whether MUST can be used instead of SGA or not.


2014 ◽  
Vol 51 (4) ◽  
pp. 331-336 ◽  
Author(s):  
Luiza Regina L S BARBOSA ◽  
Antonio LACERDA-FILHO ◽  
Livia Cristina L S BARBOSA

Context Weight loss and malnutrition are disorders observed in colorectal cancer patients. Objectives We sought to evaluate the immediate preoperative nutritional status of patients with colorectal cancer. Methods This is a cross-sectional clinical study conducted at a single center. Sixty-six consecutive patients in preoperative for elective surgical treatment were studied. The clinical history, socio-demographic data and nutritional status of the patients were evaluated using Subjective Global Assessment and objective (anthropometry) methods. The primary outcome measures were nutritional status classification as nourished or malnourished and the relationship between nutritional status and socio-demographic and clinical features. Results Most of patients exhibited left colon tumors and disease stage II. According to the Subjective Global Assessment, 36.4% of patients were malnourished. Malnutrition ranged from 7.6% to 53% depending on the evaluation method used, with poor correlation to Subjective Global Assessment. The prevalence of malnutrition was significantly greater in females and non-married patients and in those with two or more symptoms of colorectal cancer. Conclusions More than a third of patients in the immediate preoperative period for colorectal cancer exhibited malnutrition. Therefore, routine nutritional assessment is highly advisable so that appropriate measures may be taken to minimize the potential postoperative complications.


Author(s):  
Thalita Morgana Guimarães SILVEIRA ◽  
Juliana Barbosa de SOUSA ◽  
Maria Luiza Ferreira STRINGHINI ◽  
Ana Tereza Vaz de Souza FREITAS ◽  
Paulla Guimarães MELO

BACKGROUND: The assessment of nutritional status in clinical practice must be done with simple, reliable, low cost and easy performance methods. The power of handshake is recognized as a useful tool to evaluate muscle strength, and therefore, it is suggested that can detect malnutrition. AIM: To evaluate the nutritional status by subjective global assessment and power of handshake preoperatively in patients going to gastrointestinal surgeries and to compare the diagnosis obtained by subjective global assessment with traditional anthropometric methods and power of handshake. METHODS: A cross-sectional study was conducted with patients for surgery in the gastrointestinal tract and related organs. Socioeconomic and anthropometric data, applied to subjective global assessment and checked the power of handshake, were collected. The force was obtained by the average of three measurements of the dominant and non-dominant hand and thus compared with reference values of the population by sex and age, for the classification of nutritional risk. RESULTS: The sample consisted of 40 patients, 24-83 years, and most women (52.5%) housewives (37,5%) and diagnosed with cancer (45%). According to subjective global assessment, 37.5% were classified as moderately malnourished; 15% were underweight by BMI measurements; 25% had arm circumference at risk for malnutrition (<percentil 5); 60% reported recent weight loss; and 37.5% low clamping force in power of handshake on non-dominant hand (left). CONCLUSION: A significant association was observed for the diagnosis of nutritional subjective assessment with anthropometric methods and strength of the handshake only at the non-dominant limb.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Effat Afaghi ◽  
Ali Tayebi ◽  
Seyedeh Azam Sajadi ◽  
Abbas Ebadi

Background: Malnutrition is common in patients undergoing hemodialysis and leads to a decrease in dialysis adequacy. The evaluation of dialysis adequacy is very important. Objectives: This study was done to investigate the relationship between patients’ nutrition status based on Subjective Global Assessment (SGA) and their dialysis adequacy. Methods: This cross-sectional descriptive study was conducted in Tehran, Iran, in 2019. Three hundred qualified patients were selected by cluster sampling. Before the dialysis session, measurement of height and weight and blood sampling for albumin, total iron-binding capacity (TIBC), blood urea nitrogen (BUN), and creatinine (Cr) assessment were performed. After the dialysis session, measurement of weight and second sampling for BUN were done. SGA forms were filled by patients. Patients’ dialysis adequacy was calculated based on the DaugirdasII formula, and data were analyzed using SPSS 21. Results: From 300 patients, 128 cases (42.7%) had normal nutrition status, while 148 cases (49.3%) had mild to moderate malnutrition and 24 cases (8%) had severe malnutrition with mean dialysis adequacy of 1.07. The present study showed a significant statistical relationship between malnutrition and education (P < 0.001), body mass index (BMI) (P = 0.03), albumin (P < 0.001), TIBC (P < 0.001), and dialysis adequacy (P < 0.001). Gender, age, and dialysis duration showed no significant relationship with nutrition status based on the SGA index. Conclusions: The findings showed a high relative frequency of malnutrition and a decrease in patients’ dialysis adequacy, which emphasize the patient’s educational level, proper management of nutrition along with regular consultations by nutritionists, better implementation of the dialysis procedure, and regular follow-up of dialysis adequacy.


Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2097 ◽  
Author(s):  
Helen Vidot ◽  
Katharine Kline ◽  
Robert Cheng ◽  
Liam Finegan ◽  
Amelia Lin ◽  
...  

Introduction: Obesity co-exists with malnutrition and muscle atrophy in patients with cirrhosis. Muscle wasting is a feature of sarcopenia, a known determinant of patient outcomes. This is the first description of a relationship between obesity, subjective global assessment (SGA) of nutritional status and muscle wasting in patients with cirrhosis. Methods: The relationship between body mass index (BMI with obesity defined as ≥ 30 kg/m2), nutritional status (assessed by liver-specific subjective global assessment—SGA) and muscle wasting (assessed by corrected total cross-sectional psoas muscle area—cTPA) was analysed in patients with cirrhosis considered for liver transplantation between 1 January 2012 and 31 December 2014. Results: There were 205 patients, of whom 70% were males. The mean age was 52 ± 0.7 years and the Model for End-Stage Liver Disease (MELD) score was 16.8 ± 0.5. Overall, 31% of patients were obese and 56% of well-nourished (SGA A) individuals were obese. Muscle wasting was identified in 86% of all patients, irrespective of their nutritional status (A, B, C). All obese males classified as well-nourished (SGA A) were sarcopenic and 62% of obese females classified as SGA A were sarcopenic. Muscle wasting was worse in obese individuals (cTPA 230.9 mm2/m2 ± 12.9, p < 0.0001) and more likely to be associated with hepatic encephalopathy (p = 0.03). Univariate and multivariate analysis demonstrated testosterone deficiency was significantly associated with muscle wasting (p = 0.007) but not obesity (p = 0.8). Conclusion: Obesity combined with muscle wasting is common in patients with cirrhosis. Muscle wasting is common in well-nourished (SGA A) obese patients. Consequently, all patients assessed for liver transplantation should undergo additional screening for malnutrition and muscle wasting irrespective of BMI.


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