Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Réseau de Santé Vitalité Health Network, Campbellton, New Brunswick, Canada.
Nutr Clin Pract. 2021 Oct;36(5):942-956. doi: 10.1002/ncp.10613. Epub 2020 Dec 29.
The subjective global assessment (SGA) is a nutrition assessment tool that refers to an overall evaluation of a patient's history and physical examination and uses structured clinical parameters to diagnose malnutrition. The SGA is known to be a reliable and valid tool that predicts morbidity and mortality associated with malnutrition. The objective of SGA is to identify patients likely to benefit from nutrition intervention and therefore to identify persons in whom inadequate nutrition intake or absorption explain features of malnutrition, including body wasting. There are other conditions that cause weight loss, muscle wasting, and fat loss, including cachexia and sarcopenia. Acknowledging that these 2 last conditions differ in their mechanism of body wasting and consequently in the outcomes of nutrition intervention, the practitioner needs a tool to identify when malnutrition is the dominating factor to explain body wasting. The SGA form has been revised to clearly reflect the key concepts behind the diagnosis of malnutrition and help to distinguish this condition from other wasting conditions. This review presents the revised SGA form and guidance document. Using case studies, it illustrates the 3 wasting conditions, their overlap, and how the SGA identifies malnutrition as a dominating factor of body wasting and thus individuals who require nutrition intervention.
主观整体评估（SGA）是一种营养评估工具，指的是对患者的病史和体检进行全面评估，并使用结构化的临床参数来诊断营养不良。SGA 是一种可靠且有效的工具，可预测与营养不良相关的发病率和死亡率。SGA 的目的是识别可能受益于营养干预的患者，因此识别出那些营养摄入或吸收不足解释营养不良特征的人，包括身体消瘦。还有其他导致体重减轻、肌肉减少和脂肪减少的疾病，包括恶病质和肌少症。由于这最后两种疾病的身体消瘦机制不同，因此营养干预的结果也不同，医生需要一种工具来识别何时营养不良是导致身体消瘦的主要因素。SGA 表格已经过修订，以清楚地反映出营养不良诊断背后的关键概念，并有助于将这种情况与其他消瘦疾病区分开来。本综述介绍了修订后的 SGA 表格和指导文件。通过案例研究，它说明了 3 种消瘦疾病、它们的重叠以及 SGA 如何将营养不良确定为身体消瘦的主导因素，从而识别出需要营养干预的个体。
