Value of the modified Patient-Generated Subjective Global Assessment in indicating the need for nutrition intervention and predicting overall survival in patients with malignant tumors in at least two organs

Nutr Clin Pract. 2024 Aug;39(4):920-933. doi: 10.1002/ncp.11140. Epub 2024 Mar 9.

Abstract

Background: Although the Patient-Generated Subjective Global Assessment (PG-SGA) is a reference standard used to assess a patient's nutrition status, it is cumbersome to administer. The aim of the present study was to estimate the value of a simpler and easier-to-use modified PG-SGA (mPG-SGA) to evaluate the nutrition status and need for intervention in patients with malignant tumors present in at least two organs.

Methods: A total of 591 patients (343 male and 248 female) were included from the INSCOC study. A Pearson correlation analysis was conducted to assess the correlation between the mPG-SGA and nutrition-related factors, with the optimal cut-off defined by a receiver operating characteristic curve (ROC). The consistency between the mPG-SGA and PG-SGA was compared in a concordance analysis. A survival analysis was used to determine the effects of nutritional intervention among different nutrition status groups. Univariable and multivariable Cox analyses were applied to evaluate the association of the mPG-SGA with the all-cause mortality.

Results: The mPG-SGA showed a negative association with nutrition-related factors. Individuals with an mPG-SGA ≥ 5 (rounded from 4.5) were considered to need nutritional intervention. Among the malnourished patients (mPG-SGA ≥ 5), the overall survival (OS) of those who received nutrition intervention was significantly higher than that of patients who did not. However, the OS was not significantly different in the better-nourished patients (mPG-SGA < 5).

Conclusion: Our findings support that the mPG-SGA is a feasible tool that can be used to guide nutritional interventions and predict the survival of patients with malignant tumors affecting at least two organs.

Keywords: cancer; malnutrition; nutrition assessment; nutrition status; survival.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Malnutrition / mortality
  • Middle Aged
  • Neoplasms* / mortality
  • Nutrition Assessment*
  • Nutritional Status*
  • ROC Curve
  • Survival Analysis