Clinical Nutrition Department, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA.
JPEN J Parenter Enteral Nutr. 2013 Sep;37(5):659-66. doi: 10.1177/0148607112452000. Epub 2012 Jun 22.
Underweight children admitted to the pediatric intensive care unit (PICU) have a higher risk of mortality than normal-weight children. The authors hypothesized that subjective global nutrition assessment (SGNA) could identify malnutrition in the PICU and predict nutrition-associated morbidities.
The authors prospectively evaluated the nutrition status of 150 children (aged 31 days to 5 years) admitted to the PICU with the use of SGNA and commonly used objective anthropometric and laboratory measurements. Each child was administered the SGNA by a dietitian while anthropometric measurements were performed by an independent assessor. To test interrater reproducibility, 76 children had SGNA performed by another dietitian. Occurrence of nutrition-associated complications was documented for 30 days after admission.
SGNA ratings of well nourished, moderately malnourished, or severely malnourished demonstrated moderate to strong correlation with several standard anthropometric measurements (P < .05). The laboratory markers did not demonstrate any correlation with SGNA. Interrater agreement showed moderate reliability (κ = 0.671). Length of stay, pediatric logistic organ dysfunction, and Pediatric Risk of Mortality III were not significantly different across the groups and did not correlate with SGNA.
相比于正常体重的儿童，入住儿科重症监护病房（PICU）的体重不足的儿童具有更高的死亡率。作者假设主观整体营养评估（SGNA）可以识别 PICU 中的营养不良，并预测与营养相关的发病率。
作者前瞻性地评估了 150 名（年龄 31 天至 5 岁）入住 PICU 的儿童的营养状况，使用 SGNA 和常用的客观人体测量学和实验室测量。营养师对每个儿童进行 SGNA 评估，而独立评估员则进行人体测量学评估。为了测试评分者间的可重复性，对 76 名儿童进行了另一位营养师的 SGNA 评估。记录了入住后 30 天内与营养相关的并发症的发生情况。
SGNA 的营养良好、中度营养不良或严重营养不良的评分与几个标准的人体测量学测量值具有中度到高度的相关性（P<.05）。实验室标志物与 SGNA 没有相关性。评分者间的一致性显示出中度可靠性（κ=0.671）。住院时间、儿科逻辑器官功能障碍和儿科死亡率风险评分 III 在各组之间没有显著差异，也与 SGNA 无关。
