Detsky A S, McLaughlin J R, Baker J P, Johnston N, Whittaker S, Mendelson R A, Jeejeebhoy K N
JPEN J Parenter Enteral Nutr. 1987 Jan-Feb;11(1):8-13. doi: 10.1177/014860718701100108.
Presented and described in detail is a clinical technique called subjective global assessment (SGA), which assesses nutritional status based on features of the history and physical examination. Illustrative cases are presented. To clarify further the nature of the SGA, the method was applied before gastrointestinal surgery to 202 hospitalized patients. The primary aim of the study was to determine the extent to which our clinician's SGA ratings were influenced by the individual clinical variables on which the clinicians were taught to base their assessments. Virtually all of these variables were significantly related to SGA class. Multivariate analysis showed that ratings were most affected by loss of subcutaneous tissue, muscle wasting, and weight loss. A high degree of interobserver agreement was found (kappa = 0.78, 95% confidence interval 0.624 to 0.944, p less than 0.001). We conclude that SGA can easily be taught to a variety of clinicians (residents, nurses), and that this technique is reproducible.
本文详细介绍了一种名为主观全面评定法（SGA）的临床技术，该技术基于病史和体格检查的特征来评估营养状况。文中给出了示例病例。为进一步阐明SGA的本质，该方法在胃肠手术前应用于202名住院患者。本研究的主要目的是确定临床医生的SGA评分受其用于评估的各个临床变量影响的程度。实际上所有这些变量都与SGA分级显著相关。多变量分析表明，评分受皮下组织减少、肌肉消瘦和体重减轻的影响最大。观察者间一致性程度较高（kappa = 0.78，95%置信区间0.624至0.944，p < 0.001）。我们得出结论，SGA能够轻松传授给各类临床医生（住院医师、护士），且该技术具有可重复性。
