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Journal of Parenteral and Enteral Nutrition
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Journal Article

What is subjective global assessment of nutritional status?

AS Detsky, McLaughlin, JR, JP Baker, N Johnston, S Whittaker, RA Mendelson and KN Jeejeebhoy

Presented and described in detail is a clinical technique called subjective global assessment (SGA), which assesses nutritional status based on features of the history and physical examination. Illustrative cases are presented. To clarify further the nature of the SGA, the method was applied before gastrointestinal surgery to 202 hospitalized patients. The primary aim of the study was to determine the extent to which our clinician's SGA ratings were influenced by the individual clinical variables on which the clinicians were taught to base their assessments. Virtually all of these variables were significantly related to SGA class. Multivariate analysis showed that ratings were most affected by loss of subcutaneous tissue, muscle wasting, and weight loss. A high degree of interobserver agreement was found (kappa = 0.78, 95% confidence interval 0.624 to 0.944, p less than 0.001). We conclude that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible.

Journal of Parenteral and Enteral Nutrition, Vol. 11, No. 1, 8-13 (1987)
DOI: 10.1177/014860718701100108
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JPEN J Parenter Enteral Nutr, March 1, 2000; 24(2): 52 - 55.
[Abstract] [PDF]

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S. Hirsch, M P. de la Maza, V. Gattas, G. Barrera, M. Petermann, M. Gotteland, C. Munoz, M. Lopez, and D. Bunout
Nutritional Support in Alcoholic Cirrhotic Patients Improves Host Defenses
J. Am. Coll. Nutr., October 1, 1999; 18(5): 434 - 441.
[Abstract] [Full Text] [PDF]

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M. I. T. D. Correia
Assessing the Nutritional Assessment
Nutr Clin Pract, June 1, 1999; 14(3): 142 - 143.
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A.S.P.E.N. Board of Directors
Standards for Home Nutrition Support
Nutr Clin Pract, June 1, 1999; 14(3): 151 - 162.
[PDF]

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E. FIACCADORI, M. LOMBARDI, S. LEONARDI, C. F. ROTELLI, G. TORTORELLA, and A. BORGHETTI
Prevalence and Clinical Outcome Associated with Preexisting Malnutrition in Acute Renal Failure: A Prospective Cohort Study
J. Am. Soc. Nephrol., March 1, 1999; 10(3): 581 - 593.
[Abstract] [Full Text]

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C. Ireton-Jones
Considerations in Nutrition Support Practice: Obesity
Nutr Clin Pract, August 1, 1997; 12(4): 147 - 148.
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 JPEN J Parenter Enteral NutrHome page
S. Klein, J. Kinney, K. Jeejeebhoy, D. Alpers, M. Hellerstein, M. Murray, and P. Twomey
Nutrition Support in Clinical Practice: Review of Published Data and Recommendations for Future Research Directions: Summary of a Conference Sponsored by the National Institutes of Health, American Society for Parenteral and Enteral Nutrition, and American Society for Clinical Nutrition
JPEN J Parenter Enteral Nutr, May 1, 1997; 21(3): 133 - 156.
[Abstract] [PDF]

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Standards for Nutrition Support: Hospitalized Patients
Nutr Clin Pract, December 1, 1995; 10(6): 208 - 218.
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P. Charney
Nutrition Assessment in the 1990s: Where Are We Now?
Nutr Clin Pract, August 1, 1995; 10(4): 131 - 139.
[Abstract] [PDF]

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D. S. Kovacevich, C. L. Braunschweig, and P. Couch
Clinical Rounds With Nutrition Support Services: From The University of Michigan
Nutr Clin Pract, April 1, 1994; 9(2): 73 - 78.
[PDF]

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 JAMAHome page
A. S. Detsky, P. S. Smalley, and J. Chang
Is This Patient Malnourished?
JAMA, January 5, 1994; 271(1): 54 - 58.
[Abstract] [PDF]

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L. Ott and B. Young
Invited Review: Nutrition in the Neurologically Injured Patient
Nutr Clin Pract, December 1, 1991; 6(6): 223 - 229.
[Abstract] [PDF]

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 JPEN J Parenter Enteral NutrHome page
K.N. Jeejeebhoy, A.S. Detsky, and J.P. Baker
Assessment of Nutritional Status
JPEN J Parenter Enteral Nutr, September 1, 1990; 14(5_suppl): 193S - 196S.
[PDF]

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L. Ott, B. Young, R. Phillips, and C. McClain
Brain Injury and Nutrition
Nutr Clin Pract, April 1, 1990; 5(2): 68 - 73.
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R. C. Ziegenbein
Focused Review Criteria for Central Parenteral Nutrition
Nutr Clin Pract, February 1, 1989; 4(1): 24 - 30.
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R. J. Karp
The Use of the 'At-Risk' Concept To Identify Malnourished Hospitalized Patients: How a Two-Step Process Improves Clinical Acumen
Nutr Clin Pract, August 1, 1988; 3(4): 150 - 153.
[PDF]

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 ANN INTERN MEDHome page
A. S. DETSKY, J. P. BAKER, K. O'ROURKE, and V. GOEL
Perioperative Parenteral Nutrition: A Meta-Analysis
Ann Intern Med, August 1, 1987; 107(2): 195 - 203.
[Abstract] [PDF]