Subjective Global Assessment Can Be Performed in Critically Ill Surgical Patients as a Predictor of Poor Clinical Outcomes

• Published in: Nutrition in clinical practice 2019-02, Vol.34 (1), p.131-136
• Main Authors: Gattermann Pereira, Thainá, da Silva Fink, Jaqueline, Tosatti, Jéssica Abdo Gonçalves, Silva, Flávia Moraes
• Format: Article
• Language: English
• Subjects: critical care outcomes; critical illness; intensive care unit; length of stay; Nursing; nutrition assessment; subjective global assessment
• ISSN: 0884-5336; 1941-2452
• DOI: 10.1002/ncp.10178

Background There is limited evidence on the applicability of subjective global assessment (SGA) in critically ill patients, despite its good performance in diagnosing undernutrition in clinical and surgical patients. Our aim was to evaluate the association between SGA and anthropometric measures and the performance of SGA in predicting clinical outcomes and mortality in critically ill surgical patients. Methods This observational prospective study was carried out with patients admitted to the surgical intensive care unit (SICU) of a Brazilian hospital. Nutrition assessment comprised anthropometric measures (weight and height for body mass index [BMI] calculation, mid‐arm circumference [MAC] and calf circumference [CC]), and the SGA. Patients were followed up until hospital discharge for measurement of the following outcomes: length of stay (LOS), SICU LOS, and hospital mortality. Results: This study included 76 surgical patients admitted to an SICU (64.9% males; 87% white ethnicity; mean age, 60.36 ± 16.24 years). According to the SGA, the prevalence of undernutrition was 60.5% (moderate undernutrition = 38.2%; severe undernutrition = 22.4%), and well‐nourished 39.0%. Patients with severe undernutrition had lower values of current weight, BMI, MAC, and CC compared with well‐nourished patients. The presence of undernutrition increased the risk of LOS >31 days by 2.57 (1.38–4.77) times, but it was not associated with mortality. Conclusions: Patients with severe undernutrition had lower current weight, BMI, MAC, and CC compared with well‐nourished patients. Undernutrition did not increase the risk of death; however, it did increase the relative risk for a longer hospital stay by 2.5.