Subjective Global Assessment Tool Research Articles

Prevalence and factors associated with malnutrition on patients with cancer in Bangladesh: a cross-sectional study

IntroductionMalnutrition is related to the development of chronic diseases, including cancer and is a major cause of mortality in patients with cancer. The study aimed to understand the prevalence and...

Dietetics student contribution to addressing malnutrition in residential aged care facilities.

To test a model of malnutrition screening and assessment conducted by dietetics students on placement in residential aged care facilities. The secondary aim was to identify possible facilitators and barriers to the implementation of the model. The type 1 hybrid effectiveness-implementation trial study design and reporting outcomes were developed using the Consolidated Framework for Implementation Research. An innovative placement model was developed, where students on voluntary placement visited three residential aged care facilities to identify residents at risk of malnutrition using currently available screening tools for older people. Students completed malnutrition assessments for all residents using the subjective global assessment tool. Thirty-two students participated; 31 completed all three sessions, with malnutrition screening completed for 207 residents and malnutrition assessment for 187 residents (July and September 2022). Based on the subjective global assessment, 31% (n = 57) of residents were mildly/moderately malnourished, and 3% (n = 5) were severely malnourished. The Innovation Domain of the Framework was the most important consideration before implementation. Whilst previous research documented student learning opportunities in residential aged care facilities, this study provides the first available evidence of the direct contribution students can make to the health of aged care residents through malnutrition screening and assessment. The model enables students to conduct malnutrition screening and assessment feasibly and efficiently in facilities that do not routinely collate and act on these data. With a limited nursing aged care workforce to undertake this vital task, the potential role of student dietitians to fulfil this role must be considered.

Evaluation of Nutritional Status in Cancer Patients Underwent Radiotherapy: The Results of Biochemical, Body Composition with Bioelectrical Impedance Analysis, Anthropometric Measurements, and Patient-Generated Subjective Global Assessment

Aim: This study aims to evaluate the nutritional status and the effect of radiotherapy (RT) on nutrition in all ambulatory cancer patients. Material and Method: In this prospective observational study 105 cancer patients with various diagnoses treated between 2013 and 2014 were evaluated. All patients were ≥18 years old and had Karnofsky Performance Status ≥70. Anthropometric measurements, body composition with bioelectric impedance, and patient-generated Subjective Global Assessment (PG-SGA) tools were used. The height, weight, body mass index (BMI), triceps skin fold thickness, mid-upper arm circumference, hemoglobin, and serum albumin levels were determined twice before and after RT. Additionally, nutrition-related symptoms and short-term weight loss results were determined by PG-SGA questionnaires. Results: The patients’ median age was 53 years (range, 18-82 years). At initial evaluation 74 patients were well nourished using the PG-SGA global rating. Malnutrition developed in totally 33 of these 74 patients after RT. The PG-SGA results after RT were significantly worse than before treatment. PG-SGA revealed no significant relationship between nutritional status prior to RT and the parameters including gender, age, mean weight, BMI, disease duration, pre-RT hemoglobin and albumin levels. Post-RT evaluation showed a significant relationship between deterioration (PG-SGA B-C) and mean weight, BMI, serum albumin, hemoglobin levels, and concomitant chemotherapy. Gastrointestinal and head and neck cancer patients had the most deterioration after RT. The patients' weight, BMI, fat-free mass, total body water, and the percentage weight loss at the end of RT were significantly lower than the initial assessment. Conclusion: It is considerable to use multiple tools for nutritional monitoring. Patients who received RT to the head and neck and upper abdomen region had a high risk of deterioration after treatment. These patients should be monitored carefully during all treatment periods.

Hospital Associated Variation in Nutritional Status and Dietary Compliance of Elderly Patients

Background: Malnutrition is associated with detrimental aftermaths for patients including increased infections, complications, exacerbated muscle loss, prolonged hospital stay, and is often underdiagnosed. Objective: The study was carried out to determine the hospital associated variability of nutritional status, impact of length of stay on malnutrition in geriatrics. Methods: A sample of 100 participants was selected for a single group pretest posttest quasi experimental study. Interviewer administered questionnaire and Subjective Global Assessment (SGA) tool were used to collect data both at the time of admission and discharge. Within group pre-admission and post-discharge outcomes including nutrition practices, dietary compliance and nutritional status assessed by SGA were compared. Results: The BMI of the participants decreased at the time of discharge (22.89±4.44 kg/m2 pretest vs. 22.25±4.46 kg/m2 posttest) and more adults were categorized undernourished (13% in pretest vs.17% in posttest). A significant decrease in well-nourished participants (45.0% pretest vs. 32.0% posttest), and increased malnourished individuals (12.0% pretest vs. 25.0% posttest) was observed. Conclusion: Length of stay along with dietary constraints in geriatrics affects the nutritional status drastically. Targeted dietetic interventions can decrease hospital associated malnourishment. Dietary compliance of hospitalized patients can be ensured by educating the patient/caregiver to reduce the risk of malnutrition and hospital readmission. Patients already malnourished at admission are more prone to have deteriorating health.

An Analytical Cross-Sectional Study of Malnutrition in Hemodialysis Patients in Gorgan, Iran, 2020

Background: Malnutrition is relatively common in hemodialysis (HD) patients, which increases the risk of mortality. Seven Point Subjective Global Assessment (7-point SGA) tool is recommended to evaluate and monitor malnutrition in HD patients. The aim of this study was to investigate malnutrition using 7-point SGA in HD patients referred to dialysis centers in Gorgan city (north-eastern of Iran) in 2020. Methods: The nutritional status of 133 HD patients referred to Gorgan city dialysis center in 2020 were assessed using the 7-point SGA tool. Weight, percentage of fat, and muscle mass were measured by Omron BF511. Height was measured using the SECA portable stadiometer. Serum hemoglobin levels were recorded based on the latest recorded routine tests during the last month. A demographic information questionnaire was completed for all individuals. Medications and supplements taken by patients as well as visits by a nutrition consultant and adherence to a special diet were investigated by reviewing the medical file and asking the patient. Results: Out of 133 patients, 43.61% had no malnutrition and 56.39% had moderate malnutrition. The nutrition status was not different regarding gender and education level, but was different regarding household size (P=0.032). Patients with moderate malnutrition were older and had less weight and body mass index (BMI), but there was no statistically significant difference between height, dialysis time span, body fat and muscle mass percentage, and serum hemoglobin concentration. Conclusion: This study showed a considerable rate of malnutrition in HD patients, which should be regarded by clinicians and health policymakers.

Assessment of Nutritional Status Using SGA (Subjective Global Assessment) and MIS (Malnutrition Inflammation Score) Tools in Hemodialysis Patients

Introduction: One of the problems often found in patients undergoing hemodialysis is changes in their nutritional status. Patients with hemodialysis who are malnourished have a higher risk of disease and death. This nutritional disorder can be overcome by assessing nutritional status. Apart from using the SGA (Subjective Global Assessment) method, the MIS (Malnutrition Inflammation Score) method can also be used. The aim of this study was to compare differences in nutritional status of patients on hemodialysis using the SGA and MIS instruments. Methods: This research was a quantitative research with a cross-sectional design. The research sample consisted of 75 patient with hemodialysis at one of military hospital, who were selected using non-probability techniques with a total sampling approach. The statistical test used is the Mann-Whitney test with level of significance 0.05 to compare differences between variables. Results: Using the SGA tool, it was found that more than half of respondents (66.7%) were in the moderate nutrition category, while only 9.3% were in the malnutrition category. In contrast, with MIS tools, it was found that 34.7% were in the mild malnutrition and not malnourished category, while 65.3% were in the moderate to severe malnutrition category. Furthermore, statistical analysis shows that there is a significant difference (p = 0.001) between the use of SGA and MIS in assessing nutritional status in patients with hemodialysis. Conclusion: It can be concluded that there is a difference between the use of SGA and MIS in assessing nutritional status in patients with hemodialysis. Further research, could explore more for the advantages and disadvantages of each instrument, including the level of accuracy and sensitivity.

Nutritional status and post-operative complications in patients undergoing surgery for advanced pharyngeal or laryngeal cancer

PurposeMalnutrition is an important prognostic indicator of post-operative outcomes in patients undergoing surgery for head and neck cancer, however, limited studies utilize validated nutrition assessment tools to accurately assess risk. The aim of this study was to determine the relationship between nutritional status on post-operative complications and length of stay for patients undergoing either a laryngectomy, pharyngectomy or pharyngolaryngectomy for head and neck cancer.MethodsPatients with head and neck cancer undergoing a laryngectomy, pharyngectomy or pharyngolaryngectomy at a tertiary hospital in Australia were eligible for this retrospective cohort study (n = 40). Nutritional status was assessed by the dietitian on admission using the validated Subjective Global Assessment tool. Clinical outcomes were collected via retrospective chart review and included length of stay and post-operative complications.ResultsPre-operative malnutrition incidence was 40%. Malnourished patients had higher incidences of any type of complication (57% vs 44%, p = 0.013) and pressure injury (86% vs 14%, p = 0.011) compared to well-nourished patients. Well-nourished patients had a clinically important shorter median length of stay compared to malnourished patients (17.5 vs 20 days).ConclusionEarly identification and management of malnutrition is essential to minimize risk of post-operative complications and reduce length of stay and should be considered a key component of prehabilitation programs.

Peripheral parenteral nutrition: An evaluation of its use, safety and cost implications in a tertiary hospital setting

Malnutrition is a common challenge among hospitalised patients and its associatiation with poor patient health-related outcomes places a significant financial burden on the healthcare system. Total parenteral nutrition (TPN) is the primary means for providing nutrition to individuals in whom enteral feeding is not possible but is costly and requires invasive central venous access. Peripheral parenteral nutrition (PPN) provides a suitable option for early nutrition provision in select patients; however, its routine use has been limited by safety and tolerability concerns, with high rates of phlebitis reported in previous studies. The objectives of this study were to review the use, safety, and costs of PPN in an Australian tertiary hospital. A single-site, prospective observational study was conducted over 15 months in a tertiary hospital. 139 participants (87 male and 52 female) were enrolled in the study. Data collected assessed the indication for PPN initiation, compliance with the hospital's protocols for PPN, total fasting days, the proportion of the patient's total energy and protein requirements provided by PPN, the incidence of phlebitis and potential cost implications associated with the use of PPN. 139 patients (62.6% male), median age 62 years (IQR (interquartile range) 48-74) were enrolled. Most patients had an emergency admission (80.6%) under a general surgical team (84.2%). Forty-eight patients (34.5%) were malnourished, as assessed by the Subjective Global Assessment tool (SGA). Patients fasted for a median of 3 days (IQR 2-5) before PPN commencement, with a median duration of PPN use of 3 days (IQR 2-4). PPN provided an average of 61.6% of the patients' required caloric intake and 46.4% of protein requirements. Progression to TPN was observed in 34.5% of patients. There were low rates of complications with phlebitis observed in 3.7%, extravasation in 1.1%, and no patients developed septicaemia, despite suboptimal compliance with the recommended cannula management guidelines for PPN (66.4% compliant). The cost of PPN was estimated to be AUD$187 per patient day. PPN is an effective short-term nutrient delivery solution to facilitate early feeding with small numbers of patients requiring transition to TPN. PPN was safe with low rates of cannula complications. Costs were favourable, with potentially significant cost savings as compared with TPN.

Risk screening, nutrition assessment and associated factors of malnutrition among elderly inpatients in Hue University of Medicine and Pharmacy Hospital

Background: Undernutrition is a significant risk factor for mortality, complications, hospital infections, length of hospital stay, quality of life, and prognosis. Patients with proper nutrition will help prevent undernutrition, prevent the development of the disease, and improve the effectiveness of treatment. Nutrition is an integral part of the comprehensive treatment process. Nutritional risk screening is one criterion that shows the hospital’s nutritional care capacity. Assessing nutritional status plays an essential role in treating and recovering health. This study aims (1) to screen and assess the nutritional status of inpatients aged from 60 years old in Hue University Medicine and Pharmacy Hospital and (2) to identify some factors related to malnutrition. Methods: A cross-sectional study was carried out on 389 inpatients at two departments of internal medicine, Hue University of Medicine and Pharmacy Hospital, from 11/2020 - 03/2021. We used the mini nutritional assessment tool for screening nutrition risks. The subjective global assessment tool was used to assess nutritional status and questionnaires to understand some related factors. Results: There were 68.9% of patients at risk of malnutrition and 38.8% of patients had malnutrition. There were significant relationships between the nutrition status of patients with re-admitted status (p < 0.05), including diseases (p < 0.05), oral pathology (p < 0.05), decreased taste (p < 0.05). Conclusion: The prevalence of inpatients with nutritional risk in two departments of internal medicine was relatively high. It is necessary to conduct nutrition screening in all inpatients to improve the effectiveness of treatment and comprehensive care. Key words: malnutrition, inpatients, nutrition treatment, subjective global assessment tool, mini nutritional assessment tool.

Nutritional Assessment in Early Allogenic Hematopoietic Stem Cell Transplant Patients, a Cross-Sectional Study

Background Our study aims to comprehensively assess nutrition status and malnutritional prevalence in early allogenic hematopoietic stem cell transplant (allo-HSCT) patients. Methods This single-center, cross-sectional study included 171 patients within the 90 days post-transplantation (from September 2019 to April 2020). Data collected included demographic, 3 day 24-h diet record, a Patient-Generated Subjective Global Assessment (PG-SGA) tool, laboratory tests, anthropometric indices, and body composition. Results One hundred and seventy-one patients with a mean age of 37.8 ± 11.3 and a male to female ratio of 102 to 69 were included. According to PG-SGA, 115 (67.3%) indicated the critical need for nutritional intervention and symptom management (PG-SGA score > 9). Forty-three (43.3%) of patients had experienced insufficient intakes of energy according to a 24-h diet record. Our study found that 120 (70.2%) patients had a body fat percentage and high triacylglycerol (64.9%). Reduced free fat mass index and low hand-grip strength were found in 133 (77.78%) and 104 (60.81%), respectively. The prevalence of malnutrition was 24.6% and the prevalence of sarcopenia was 13.5%. Conclusion Although the prevalence was not high, this research has demonstrated a high risk of malnutrition and a lower muscle mass in early allo-HSCT. Furthermore, our study confirmed body composition assessment would be an excellent way to identify malnutrition precisely.

Current situation of enteral tube feeding for patients at Nghe An General Friendship Hospital

Enteral tube feeding is a method to supply nutrients for critically ill patients, reducing the risk of infection, using normal bowel function, avoiding villous atrophy, reducing the possibility of electrolyte imbalance, reducing treatment costs and safe for patients. This paper aims to study the current situation of patients with feeding tubes at Nghe An General Friendship Hospital. The reseacrch applied a descriptive prospective method to study 255 patients, from April 2022 to June 2022, in Intensive Care, Surgical Intensive Care, Poison Control Department, General Infections Department, Stroke Center, Burns and Gastrointestinal Surgery Departments. Results showed that the malnutrition rate assessed by BMI (Body mass index) was 14.5%, by MUAC (Mid-upper arm circumference) was 6.7%, by SGA (Subjective global assessment) was 54.9%, by serum albumin index was 79.2%. On the first day of enteral tube feeding, the combining rate of enteral and parenteral nutrition was 45.9%, on the 7th day, it was 8.2%. On the first day, the rate of hypocaloric diet was 18.8%; isocaloric diet was 56.1%; hypercaloric diet was 25.1%. On the 7th day, these rates were 38.4, 55.7, and 5.9% respectively. The total energy intake on the first day and the 7th day achieved 75.5 and 85.9% recommended dietary allowance respectively. In conclusion, the rate of malnourished patients in hospitalised was high (assessed by SGA tool 54.9% and serum albumin index 79.2%), most patients are provided energy to meet the recommended dietary allowance. In the early days, the percentage of patients receiving combined parenteral and enteral was high, then gradually reducing parenteral, switching to complete enteral nutrition.

Validation Of Nutrition Screening Tool: Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) For Chronic Liver Disease Patients

Introduction: Hepatic diseases patients are especially prone to malnutrition, which is often underestimated. Screening tools were developed to detect the risk of malnutrition. However, screening tools for patients with liver disease were frequently underestimated. Fluid overload is the main issue to perform nutritional screening in liver disease patients. Therefore, this study aimed to validate the Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) among patients and to evaluate association between RFH-NPT, Nutritional Risk Screening (NRS 2002) and Subjective Global Assessment (SGA). Methods: This cross sectional study was conducted in 3 phases; transcultural adaptation, criterion validity and reliability phases. Content validity was confirmed by interviewing eight liver disease professionals. Face validity was assessed by surveying forty nurses working in the liver disease ward. In addition, agreement between NRS 2002 and RFH-NPT assessment was assessed using the SGA tool. Results: Eighty patients with liver disease took part in this study. The SGA assessment found malnutrition in 75% of patients (95% CI, 60%–95%) while 80% (95% CI, 65%-80) were found as at risk of malnutrition using RFH- NPT. Moderate specificity and high sensitivity of RFH-NPT were 97% and 74%, respectively, and 95% positive predictive value was measured. Conclusion: The RFH-NPT nutritional screening tool is the initial and most reliable in this population to assess the malnutrition risk. Thus, inclusion of the RFH-NPT with NRS 2002 demonstrated positive and a fair agreement between the SGA and RFH-NPT tool to be used as a routine nutrition screening protocol for identifying patients at risk of malnutrition.

Blood biomarkers as potential malnutrition screening alternatives among adult patients with cancer on treatment in oncology unit of jimma tertiary hospital: A cross-sectional analysis

BackgroundCancer is becoming the most common global public health concern. Early malnutrition detection and treatment in patients with cancer is an important aspect of cancer management. Although Subjective global assessment (SGA) is a gold standard nutritional assessment tool, it is not routinely utilized due to it is tedious and needs patient literacy. Thus, early detection of malnutrition necessitates alternative parameters comparable with SGA. Therefore this study aims to evaluate serum albumin, Total Protein (TP), and Hemoglobin (Hgb) and their correlation with malnutrition in patients with cancer at Jimma Medical Center (JMC).MethodsFacility based cross-sectional study was conducted from October 15 to December 15, 2021 G.C at JMC among a total of 176 adult patients with cancer selected via a systematic sampling technique. Nutritional status and behavioural data were collected using the SGA tool and a structured questionnaire. Five ml of venous blood was collected and the level of serum albumin, TP and Hgb were measured using Cobas®6000 chemistry analyzer and hematology analyzer UniCel DxH 800. Descriptive statistics, independent t-test, Pearson’s correlation coefficient (r), and logistic regression analysis were implemented for analysis.ResultFrom the total of 176 study participants, 69.3% were females and the mean age was 50.1 ± 13.7 years. Based on SGA, 61.4% of the patients were malnourished. There was a significant decrease in the mean level of serum albumin, TP and Hgb in malnourished as compared to well-nourished patients. Serum albumin(r=-0.491), TP(r=-0.270), and Hgb (r=-0.451) had a significant correlation with SGA tool. Stage IV cancer AOR = 4.98 (1.23–20.07), Gastrointestinal (GI) cancer AOR = 3.39(1.29–8.88) and malnutrition AOR = 3.9(1.81–8.4) were significantly associated with hypoalbuminemia. Similarly, age of > 64 years AOR = 6.44(1.55–26.67), GI cancer AOR = 2.92(1.01–6.29) and malnutrition AOR = 3.14(1.43–6.94) were significantly associated with hypoproteinemia; and stage-IV cancer AOR = 3.94(1.11–13.35) and malnutrition AOR = 3.8(1.82–8.2) were significantly associated with low Hgb level.Conclusion and recommendationAltered level of serum albumin, TP and Hgb was correlated with the SGA tool of malnutrition. Therefore, it is suggested to be used as an alternative or additional screening tool for prompt detection of malnutrition in adult patients with cancer.

Validation of AND/ASPEN pediatric malnutrition diagnosis in children admitted to medical wards in two tertiary hospitals in Malaysia.

Identification and management of malnutrition among pediatric hospitalized patients is critical for improved clinical outcomes and recovery. This study investigated the use of the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition (AND/ASPEN) pediatric malnutrition diagnosis in comparison with the Subjective Global Nutritional Assessment (SGNA) tool and single anthropometric indicators (weight, height, body mass index, and mid-upper arm circumference) among hospitalized children. A cross-sectional study was conducted among 260 children admitted to general medical wards. SGNA and anthropometric measurements were used as references. Kappa agreement, diagnostic values, and area under the curve (AUC) were analyzed to evaluate the diagnostic ability of the AND/ASPEN malnutrition diagnosis tool. Logistic binary regression was performed to determine the predictive ability of each malnutrition diagnosis tool on the length of hospital stay. The AND/ASPEN diagnosis tool detected the highest malnutrition rate (41%) among the hospitalized children in comparison with the reference methods. This tool demonstrated fair specificity of 74% and sensitivity of 70% compared with the SGNA. It obtained a weak agreement in determining the presence of malnutrition by kappa (0.06-0.42) and receiver operating characteristic curve analysis (AUC = 0.54-0.72). The use of the AND/ASPEN tool obtained an odds ratio of 0.84 (95% CI, 0.44-1.61; P = 0.59) in predicting the length of hospital stay. The AND/ASPEN malnutrition tool is an acceptable nutrition assessment tool for hospitalized children in general medical wards.

GLIM Criteria for Assessment of Malnutrition in Saudi Patients with Type 2 Diabetes.

The Global Leadership Initiative on Malnutrition (GLIM) is a new approach established for the assessment of malnutrition. This study aimed to validate the GLIM for the diagnosis of malnutrition in patients with type 2 diabetes mellitus (T2DM) in Saudi Arabia, using the Subjective Global Assessment (SGA) as a reference. In addition, the association between the GLIM criteria and vascular complications in those patients was examined. A cross-sectional study was conducted on 101 patients with T2DM. The level of agreement between the GLIM and SGA tools was calculated using the kappa coefficient (κ). A receiver operating characteristic curve was used to determine the sensitivity and specificity of the GLIM. In addition, binary logistic regression was performed to investigate the association between each GLIM criterion and T2DM vascular complications. According to both the GLIM and the SGA, malnutrition was found in 15.8% and 17.8% of patients, respectively. The GLIM criteria achieved a very good level of accuracy (AUC = 0.877). The agreement between the tools was substantial (κ = 0.778). The 'disease/inflammation' criterion of the GLIM was significantly associated with macrovascular complications. To conclude, the GLIM criteria for diagnosis of malnutrition presented satisfactory levels of validity, and as such are acceptable for assessing the nutritional status of patients with T2DM.

Utility of Subjective Global Nutritional Assessment Tool for the Assessment of Malnutrition in Pediatric Patients with Chronic Liver Disease.

Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), mid-upper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.

Nutritional Assessment of Adult Patients Undergoing Maintenance Hemodialysis in the Gaza Strip

Malnutrition is a common condition in patients undergoing hemodialysis (HD), and it is associated with increased morbidity and mortality. The main objective of the study was to evaluate the nutritional status of patients on maintenance HD. After applying eligibility criteria, 141 HD patients attending major governmental dialysis centers were randomly recruited in this cross-sectional study and assessed for nutritional status using the Patient-Generated Subjective Global Assessment (PG-SGA) tool. The PG-SGA categorizes patients as well-nourished, moderately malnourished, and severely malnourished. Different anthropometric measurements, laboratory investigations, blood pressure measurements, and 24-h dietary recall were collected from each patient. According to PG- SGA results, 78% of patients were moderately malnourished and 22% of patients were severely malnourished. The mean body mass index was 27.8 kg/m2, and 5.7% of patients were underweight. There were significant differences in the mid-upper arm muscle circumference (P = 0.020) between the PG-SGA groups. The total energy and protein intake were significantly (P &lt;0.001) less than the recommended dietary intake by 1268.9 kcal and 41.4 g, respectively. The albumin level in 37.6% of patients was less than the normal level, and the results indicated that there were significant differences in serum iron (P = 0.022) between the moderately and severely malnourished patients. The results of this study indicated that all HD patients were suffering from different degrees of malnutrition and, unfortunately, most of their energy and nutrient intake was far less than the requirements, which might be the reason why they face nutritional and health risks.

Effect of a Personalized Enteral Nutrition Protocol on the Postoperative Nutritional Status in Patients Who Underwent Oral Cancer Surgery

Differences in the implementation of the perioperative nutrition guidelines and pathways by caregivers lead to differences in enteral nutrition provided to the patients. This study investigated the effect of a personalized enteral nutrition protocol on the postoperative nutritional status of patients who underwent oral cancer surgery at Zhejiang Ningbo NO. 2 Hospital. Those who underwent surgery between July 2017 and October 2018 received routine enteral nutrition based on the Nutritional Risk Screening 2002 (routine group), while those between November 2018 and August 2021 received personalized enteral nutrition based on the Patient-Generated Subjective Global Assessment tool (personalized group). Seventy patients completed the study (routine group, n = 34; personalized group, n = 36). After surgery, the personalized group exhibited significantly greater improvements in serum albumin levels (P < 0.01) (on the 7th and 10th day) and hand grip strength (P < 0.01), higher self-care ability (P < 0.01), lower incidence of gastrointestinal reactions during enteral feeding (P < 0.05), and shorter hospital stay (P < 0.05) than the routine group. Therefore, a personalized enteral nutrition program might improve the postoperative nutritional status, shorten the hospital stay, and accelerate postoperative recovery in patients who underwent oral cancer surgery.

Malnutrition among patients with Type-2 Diabetes Mellitus.

The present study aims to evaluate the nutritional status of diabetic patients using Subjective Global Assessment (SGA) tool. A prospective cross-sectional study was conducted at Endocrine and Medicine Department of Lady Reading Hospital from September 2019 to March 2020. A total of 359 patients diagnosed with Type-2 Diabetes Mellitus (T2DM) were included in the study. The malnutrition status was assessed using SGA, and clinical parameters including albumin and total leukocyte count (TLC). We have observed mild to moderate malnutrition among 48.2% patients, and severe malnutrition in 10.6% patients as per the SGA scoring. Among the factors associated with nutritional status were BMI (p<0.01), and presence of CAD (DM complication) (p=0.015). As per the correlation analysis, BMI had a significant negative correlation with nutritional status (r=-0.351; p<0.01). It is concluded from the study results that there is a high prevalence of malnutrition among the enrolled diabetic patients.

Screening of malnutrition using Patient-Generated Subjective Global Assessment tool and hand muscle strength in subjects with pancreatitis.

Pancreatitis patients are at an increased risk of malnutrition due to impaired digestion, absorption, and metabolism. The degree of malnutrition is dependent on the duration, viz. acute or chronic. Studies on nutritional status in patients with pancreatitis are limited. Prevalence of nutritional status, physical functioning, and muscle strength among the subjects are scarce globally. The main aim of this study was to screen the status of malnutrition using appropriate screening tools and to assess hand muscle strength among subjects. A cross-sectional study was conducted on 64 subjects (18-80 years old, 59 males and 5 females) in Mysore city, Karnataka. The patients were screened for malnutrition using a standard tool Patient-Generated Subjective Global Assessment (PG-SGA) and handgrip strength on both dominant and nondominant hands. The majority of patients (n = 44) were categorized as moderately malnourished/suspected malnutrition (Stage B) according to PG-SGA.A significant difference (p < 0.005) in handgrip strength was seen inmen aged 31-40 (t = -3.287)and 41-50 (t = -5.487) years compared tohealthy adults. This study was able to identify patients at risk of malnutrition when thePG-SGA tool was used along with handgrip strength and other anthropometric parameters.