Background and aims: To verify the validity of the Subjective Global Assessment (SGA) on the nutritional assessment and prognosis prediction in Chinese patients with gastrointestinal cancer.
Methods: Five hundred and five patients with newly diagnosed gastrointestinal cancer who underwent surgeries were enrolled between August 2004 and August 2006. The sample consisted of 307 males (60.8%) and 198 females (39.2%). The nutritional status was assessed using SGA for each patient prior to operation. Simultaneously, anthropometric parameters and laboratory tests including serum albumin (ALB) and prealbumin (PA) levels were also obtained. The postoperative evaluation included length of stay, occurrence of complications, and in-hospital medical expenditures.
Results: Based on the results of preoperative SGA, the patients were classified into 3 groups: well nourished (group A), mildly to moderately malnourished (group B), and severely malnourished (group C). The number in each group was 275 (54.4%), 214 (42.4%), and 16 (3.2%), respectively. ANOVA tests revealed significant group differences existed for body mass index (BMI), triceps skinfold thickness (TSF), PA, ALB, length of stay, and in-hospital medical expenditures (p<0.05). The more severely malnourished the patient, the BMI, TSF, PA, and ALB became lower, the length of stay became longer and the medical cost became higher. The occurrence of postoperative complications did not show significant difference among the different SGA groups (X(2)=4.16, p=0.125). And patients in different cancer stages (TNM staging) had no statistical differences in terms of their length of stay (F=1.433, p=0.232) and the occurrence of postoperative complications (X(2)=4.836, p=0.184).
Conclusions: The SGA is safe, inexpensive, and easy to use clinically for nurses. This study demonstrated that it can be a reliable method to assess the nutritional status of Chinese patients with gastrointestinal cancer. The SGA could also help predict certain health outcomes, such as length of stay, in-hospital medical expenditures.
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