Lin Huang-Shen, Lin Ming-Shyan, Chi Ching-Chi, Ye Jung-Jr, Hsieh Ching-Chuan
Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 33303, Taiwan.
J Clin Med. 2021 Jun 18;10(12):2702. doi: 10.3390/jcm10122702.
Malnutrition in patients with tuberculosis (TB) is associated with poor outcomes. This study assessed the validity of the patient-generated subjective global assessment (PG-SGA) in adult TB patients and examined the association of the PG-SGA score with adverse outcomes.
This is a retrospective chart review study compared with the well-nourished and malnourished TB patients. The nutritional status was determined using the PG-SGA for adult patients ( = 128). Clinical outcomes included liver injury and mortality. Adverse outcomes included hepatitis during anti-tuberculosis therapy.
By comparing nutritional status using global assessment, well-nourished patients had a significantly higher body weight index ( = 0.002), a lower PG-SGA score ( < 0.001), and lower diabetic rate ( = 0.029). Malnourishment was a risk factor ( = 0.022) for liver injury and fatal outcomes ( < 0.001). A higher PG-SGA score was a risk factor for liver injury ( = 0.002) and an independent risk factor for fatal outcomes ( = 0.031). ROC analysis for outcome prediction showed that a PG-SGA score of 5.5 points yielded the most appropriate sensitivity (61.5%) and specificity (64.7%).
Both global assessment and the total PG-SGA score were related to tuberculosis outcome and liver injury during anti-TB treatment.
肺结核（TB）患者的营养不良与不良预后相关。本研究评估了患者主观全面评定法（PG-SGA）在成年肺结核患者中的有效性，并探讨了PG-SGA评分与不良预后之间的关联。
这是一项回顾性病历审查研究，对营养良好和营养不良的肺结核患者进行了比较。使用成人PG-SGA评定营养状况（n = 128）。临床结局包括肝损伤和死亡率。不良结局包括抗结核治疗期间的肝炎。
通过整体评估比较营养状况，营养良好的患者体重指数显著更高（P = 0.002），PG-SGA评分更低（P < 0.001），糖尿病发生率更低（P = 0.029）。营养不良是肝损伤和致命结局的危险因素（P = 0.022）（P < 0.001）。较高的PG-SGA评分是肝损伤的危险因素（P = 0.002），也是致命结局的独立危险因素（P = 0.031）。结局预测的ROC分析显示，PG-SGA评分为5.5分时，敏感性（61.5%）和特异性（64.7%）最为合适。
整体评估和PG-SGA总分均与抗结核治疗期间的肺结核结局和肝损伤有关。
