Subjective assessment of nutritional status-validity and reliability of a modified Detsky index in a Swedish setting

Ulander, Kerstin; Grahn, Gertrud; Jeppsson, Bengt

doi:10.1016/0261-5614(93)90139-u

Cited by 23 publications

(26 citation statements)

References 19 publications

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“…The instrument has been tested for validity and reliability in patients with gastrointestinal and geriatric diseases (Ulander et al, 1993;Ek et al, 1996, Persson et al, 2002. SGA classifies patients into SGA A (well nourished), SGA B (moderately/suspected of being malnourished) and SGA C (severely malnourished).…”

Section: Methodsmentioning

confidence: 99%

Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Tengstrand

et al. 2007

Eur J Clin Nutr

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Objective: To evaluate diagnostic instruments for assessment of nutritional status in patients with rheumatoid arthritis (RA) in relation to objective body composition data. Subjects and methods: Study subjects include 60 in-ward patients (83% women, median age 65 years). Anthropometric measures and the nutritional tools Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening tool 2002 (NRS-2002. Body composition was determined by dual-energy X-ray absorptiometry and fat-free mass index (FFMI; kg/m 2 ) and fat mass index (FMI; kg/m 2 ) were calculated. Results: Mean body mass index (BMI) for RA women and men were 24.4 and 26.9 kg/m 2 , respectively. Twelve per cent of the women and none of the few men had BMIo18.5 kg/m 2 , that is, the cutoff value for malnutrition. FFMI indicated 52% of the women and 30% of the men to be malnourished. The sensitivity and specificity for BMI to detect malnutrition according to FFMI were 27 and 100%, whereas for arm muscle circumference the sensitivity was 36% and the specificity 89% and for triceps skin fold 43 and 93%, respectively. For MNA, sensitivity was 85% and specificity 39% and for SGA 46 and 82%. Both MUST and NRS-2002 had sensitivity of 45% and specificity of 19%. Conclusion: A large proportion of in-ward RA patients had reduced FFMI. Concurrent elevation of fat mass made BMI a nonreliable tool to detect malnutrition. Of the tested clinical evaluation tools, MNA might be used as a screening instrument, but because of its low specificity it should be followed by body composition determination.

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Section: Methodsmentioning

confidence: 99%

Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Tengstrand

et al. 2007

Eur J Clin Nutr

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“…A high degree of interobserver agreement was also found, k ¼ 0,78 (95% CI 0.62 -0.94). The tool has been translated into Swedish and tested for validity and reliability in studies of patients undergoing gastrointestinal surgery (Ulander et al, 1993), in geriatric patients (Ek et al, 1996) and in elderly patients with hip fractures (Unosson et al, 1995).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

2002

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Objectives: To evaluate the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment (MNA) with regard to validity using a combination of anthropometric and serum-protein measurements as standard criteria to assess protein-energy malnutrition (PEM). Design: Cross-sectional study with consecutive selection of residents aged ! 65 y. Setting: A municipality in the south of Sweden. Subjects: During a year, starting in October 1996, 148 females and 113 males, aged ! 65 -104 y of age, newly admitted to special types of housing for the elderly, were included in the study. Results: According to SGA, 53% were assessed as malnourished or moderately malnourished on admission. The corresponding figure from MNA was 79% malnourished or at risk of malnutrition. Both tools indicated that anthropometric values and serum proteins were significantly lower in residents classified as being malnourished (P < 0.05). Sensitivity in detecting PEM was in SGA 0.93 and in MNA 0.96 and specificity was 0.61 and 0.26, respectively. Using regression analysis, weight index and serum albumin were the best objective nutritional parameters in predicting the SGA-and MNA classifications. Item 'muscle wasting' in SGA and 'self-experienced health status' in MNA showed most predictive power concerning the odds of being assessed as malnourished. Conclusions: SGA was shown to be the more useful tool in detecting residents with established malnutrition and MNA in detecting residents who need preventive nutritional measures.

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“…Moreover, the nutritional status of the residents was assessed using a version of the subjective global assessment (SGA) (Detsky et al, 1987) that has been modified for Swedish conditions (Ulander et al, 1993). We have also made further adaptations for the assessment of older subjects (Faxén-Irving et al, 1999).…”

Section: Nutritional Statusmentioning

confidence: 99%

Nutrition education for care staff and possible effects on nutritional status in residents of sheltered accomodation

et al. 2005

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Objective: We investigated the nutritional, cognitive and functional status in residents of two service-flat (SF) complexes and the effects of a nutrition education programme for care staff. Design: Controlled nonrandomised study. Setting: Two SF complexes, that is community-assisted accommodation. Subjects: Of 115 eligible SF residents, 80 subjects participated (age 8377 y, 70% women). Intervention: The nutritional status was assessed using body mass index (BMI, kg/m 2 ), subjective global assessment (SGA), serum concentrations of albumin, insulin-like growth factor-I (IGF-I) and vitamin B 12 . Cognitive and functional status were evaluated using the Mini Mental State Examination (MMSE, 0-30 points, o24 points indicates impaired cognition) and the Katz activities of daily living (ADL) index, respectively. Two assessments were made with a 5-month interval. At the start, a 12-h education programme was given to the staff at one of the SF complexes. Results: At baseline, the means of BMI and the biochemical nutritional indices were normal, whereas one-third had BMI o22 kg/m 2 and one-fourth had lost Z10% of previous weight. According to SGA, 30% demonstrated possible or serious malnutrition. The median MMSE was 23 points (19.5-26.5, 25-75th percentile). Nearly 70% were ADL-independent. At the 5-month follow-up there were no differences in the nutritional and cognitive status of the residents. The nutritional knowledge of the staff improved slightly (Po0.05) at both SF complexes (NS between groups). Conclusions: Around one-third of SF residents appeared to be at nutritional risk. Five months after a 12-h staff nutrition education programme, no objective changes were seen in the nutritional status of the SF residents.

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Subjective assessment of nutritional status-validity and reliability of a modified Detsky index in a Swedish setting

Cited by 23 publications

References 19 publications

Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

Nutrition education for care staff and possible effects on nutritional status in residents of sheltered accomodation

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