Background: A valid malnutrition screening tool (MST) is essential to provide timely nutrition support in ambulatory cancer care settings. The aim of this study is to investigate the validity of the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) and the new Global Leadership Initiative on Malnutrition (GLIM) criteria as compared to the reference standard, the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: Cross-sectional observational study including 246 adult ambulatory patients with cancer receiving in-chair intravenous treatment at a cancer care centre in Australia. Anthropometrics, handgrip strength and patient descriptive data were assessed. Nutritional risk was identified using MST and PG-SGA SF, nutritional status using PG-SGA and GLIM. Sensitivity (Se), specificity (Sp), positive and negative predictive values and kappa (k) were analysed. Associations between malnutrition and 1-year mortality were investigated by Cox survival analyses. Results: A PG-SGA SF cut-off score ≥5 had the highest agreement when compared with the PG-SGA (Se: 89%, Sp: 80%, k = 0.49, moderate agreement). Malnutrition risk (PG-SGA SF ≥ 5) was 31% vs. 24% (MST). For malnutrition according to GLIM, the Se was 76% and Sp was 73% (k = 0.32, fair agreement) when compared to PG-SGA. The addition of handgrip strength to PG-SGA SF or GLIM did not improve Se, Sp or agreement. Of 100 patients who provided feedback, 97% of patients found the PG-SGA SF questions easy to understand, and 81% reported that it did not take too long to complete. PG-SGA SF ≥ 5 and severe malnutrition by GLIM were associated with 1-year mortality risk. Conclusions: The PG-SGA SF and GLIM criteria are accurate, sensitive and specific malnutrition screening and assessment tools in the ambulatory cancer care setting. The addition of handgrip strength tests did not improve the recognition of malnutrition or mortality risk.
COVID-19 symptoms range from severe respiratory failure to mild anorexia, cough and smell and taste alterations, adversely impacting nutritional intake. The aim of this paper was to establish malnutrition risk, Nutrition Impact Symptoms (NIS) and associations with reduced oral intake. A retrospective observational cohort of all people testing positive for COVID-19 was conducted. Malnutrition risk, nutritional status, weight, reduced oral intake and NIS on and during admission were collected. Dietetic consultation frequency and mode were captured. Some 80% (48/60) of participants reported at least one NIS, and 58% (25/60) reported two or more. Most frequent reported symptoms were cough (60%), sore throat (35%) and reduced appetite (28%). Significant associations existed between ≥2 NIS (p=0.006), reduced appetite (p=0.000) and reduced oral intake, with 20% requiring ongoing nutrition support and consultation. High NIS prevalence confirms systematised nutrition support pathways are indicated through incorporation into standard care across the healthcare continuum, including community care.
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