Raguso Comasia A, Maisonneuve Nadine, Pichard Claude
Hôpitaux Universitaires de Genève, Unité de Nutrition.
Rev Med Suisse Romande. 2004 Oct;124(10):607-10.
The subjective global assessment (SGA) defines nutritional and functional status of patients with the aim of identifying who could benefit from a nutritional intervention. The SGA was designed to evaluate the nutritional risk of infectious complications among the surgical patients. Later on, it became largely utilized to evaluate the nutritional status of other groups of patients, because it is reliable and easy to use. However, it is important to verify that the SGA is an adequate test also in other clinical situations. This review analyses recent literature regarding the actual utilization of the SGA in clinical situations frequently associated to malnutrition: kidney diseases, AIDS, cancer, aging. The reproducibility of SGA depends on the experience of the caregiver administering it. Its validation compared to more objective parameters like visceral proteins or body composition is not always obvious. In several studies the SGA does not seem enough sensitive to detect a beginning of malnutrition. Its specificity and predictive validity were demonstrated in all of the clinical situations analyzed. In conclusion, the SGA is a tool adequate to identify patients with a nutritional risk and who would benefit of a nutritional intervention aiming at preventing associated complications.
主观全面评定法(SGA)旨在确定哪些患者能从营养干预中获益,以此定义患者的营养和功能状态。SGA最初用于评估外科手术患者发生感染性并发症的营养风险。后来,因其可靠且易于使用,被广泛用于评估其他患者群体的营养状况。然而,重要的是要验证SGA在其他临床情况下也是一种合适的检测方法。本综述分析了近期有关SGA在常与营养不良相关的临床情况(肾脏疾病、艾滋病、癌症、老龄化)中的实际应用的文献。SGA的可重复性取决于实施者的经验。与诸如内脏蛋白或身体组成等更客观的参数相比,其有效性并不总是很明显。在多项研究中,SGA似乎对检测营养不良的早期阶段不够敏感。在所有分析的临床情况下,其特异性和预测有效性都得到了证实。总之,SGA是一种适用于识别有营养风险的患者以及能从旨在预防相关并发症的营养干预中获益的患者的工具。