3. To be useful nutritional assessment tool
needs to meet the following criteria:
easy to use,
cost-effective
reproducible
able to predict the risk
little interobserver variability
4. The SGA of nutritional status was
developed during the 1980s and has
been validated as a tool for triaging
patients in terms of their nutritional risk
and need for aggressive nutritional
support.
Ottery et al supplement to nutrition 1996
5. Broad Geographic
Coverage
The American Dietetic Association, ASPEN
and ESPEN recommend the use of
SUBJECTIVE GLOBAL ASSESSMENT in
clinical settings.
Being used in Europe, USA and Asia –pacific
region.
7. High Predictive value for post-
operative infections
Reproducible technique
Predictive and valid
Reliable method of assessing
nutritional status of hospitalized
patients
(Detsky JPEN 1987)
8. What is Subjective Global
Assessment?
History
Physical Examination
SGA Rating
Detsky et al JPEN 1987
ADA Manual of Clinical Dietetics (2000)
9. What is Subjective Global
Assessment?
A.History
1.Weight Change
2.Dietary Intake Change
3.Gastrointestinal Symptoms
4.Functional Capacity
5.Disease Stress
10. What is Subjective Global
Assessment?
B.Physical Examination
1.Loss of subcutaneous fats
2.Muscle wasting
3.Ankle Edema
4.Sacral Edema
5.Ascites
11. What is Subjective Global
Assessment?
C.SGA Rating
______A=Well nourished
______B=Moderately Malnourished
______C=Severely Malnourished
13. How to do SGA Rating?
Well-nourished
No wt Loss
Good Intake
No GI Symptoms
No edema,ascites
14. How to do SGA Rating?
Moderately(Grade B) or suspected to be
malnourished
15. How to do SGA Rating?
Pt who exhibited more of the features
I.e. Wt loss,
Low intake,
significant GI sysmptoms,
poor functional capacity,
loss of muscles,
loss of fats,edema,ascites etc.
16. How to do SGA Rating?
5%wt loss in few weeks prior to
admission without stabilization or
weight gain
Definite reduction in dietary intake
Mild subcutaneous tissue loss
17. How to do SGA Rating?
Grade-C;In order to receive a C rank,the
patient had to demonstrate obvious physical
signs of malnutrition(severe loss of
subcutaneous tissue,muscle wasting,and
often some edema) in presence of a clear and
convincing pattern of ongoing weight loss.
Net loss of at least 10% of the normal wt.
