Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Apr 28, 2010; 16(16): 1999-2004
Published online Apr 28, 2010. doi: 10.3748/wjg.v16.i16.1999
Comparison of two nutritional assessment methods in gastroenterology patients
Branka F Filipović, Milan Gajić, Nikola Milinić, Branislav Milovanović, Branislav R Filipović, Mirjana Cvetković, Nela Šibalić
Branka F Filipović, Nikola Milinić, Mirjana Cvetković, Department of Gastroenterohepatology, Clinical and Hospital Center “Bezanijska Kosa”, Belgrade 11080, Serbia
Milan Gajić, School of Medicine, Institute for Medical Statistics, Belgrade 11000, Serbia
Branislav Milovanović, Faculty of Cardiology School of Medicine, Belgrade 11000, Serbia and Laboratory for Neurocardiology, Clinical and Hospital Center “Bezanijska Kosa”, Belgrade 11080, Serbia
Branislav R Filipović, Institute of Anatomy “Niko Miljanic”, School of Medicine, Belgrade 11000, Serbia
Nela Šibalić, Biochemical Laboratory, Clinical and Hospital Center “Bezanijska Kosa”, Belgrade 11080, Serbia
Author contributions: Filipović BF was the main insvestigator and study designer; Milinić N, and Cvetković M performed the patient investigation and nutritional assessment; Gajić M and Filipović BR performed the statistical analysis and table design; Milovanović B performed the bioelectrical impedance analysis; Šibalić N analysed and interpreted the biochemical results.
Supported by (in part) The Grant of Ministry of Science, Technology and Development of the Republic of Serbia, No. 156031
Correspondence to: Branka F Filipović, MD, MSc, Department of Gastroenterohepatology, Clinical and Hospital Center “Bezanijska Kosa”, Autoput s/n, Belgrade 11080, Serbia.
Telephone: +381-11-3070750 Fax: +381-11-3010751
Received: November 10, 2009
Revised: December 8, 2009
Accepted: December 15, 2009
Published online: April 28, 2010

AIM: To investigate and compare efficacy and differences in the nutritional status evaluation of gastroenterology patients by application of two methods: subjective global assessment (SGA) and nutritional risk index (NRI).

METHODS: The investigation was performed on 299 hospitalized patients, aged 18-84 years (average life span 55.57 ± 12.84), with different gastrointestinal pathology, admitted to the Department of Gastroenterohepatology, Clinical and Hospital Center “Bezanijska Kosa” during a period of 180 d. All the patients, after being informed in detail about the study and signing a written consent, underwent nutritional status analysis, which included two different nutritional indices: SGA and NRI, anthropometric parameters, bioelectrical impedance analysis, and biochemical markers, within 24 h of admission.

RESULTS: In our sample of 299 hospitalized patients, global malnutrition prevalence upon admission varied from 45.7% as assessed by the SGA to 63.9% by NRI. Two applied methods required different parameters for an adequate approach: glucose level (5.68 ± 1.06 mmol/L vs 4.83 ± 1.14 mmol/L, F = 10.63, P = 0.001); body mass index (26.03 ± 4.53 kg/m2vs 18.17 ± 1.52 kg/m2, F = 58.36, P < 0.001); total body water (42.62 ± 7.98 kg vs 36.22 ± 9.32 kg, F = 7.95, P = 0.005); basal metabolic rate (1625.14 ± 304.91 kcal vs 1344.62 ± 219.08 kcal, F = 9.06, P = 0.003) were very important for SGA, and lymphocyte count was relevant for NRI: 25.56% ± 8.94% vs 21.77% ± 10.08%, F = 11.55, P = 0.001. The number of malnourished patients rose with the length of hospital stay according to both nutritional indices. The discriminative function analysis (DFA) delineated the following parameters as important for prediction of nutritional status according to SGA assessment: concentration of albumins, level of proteins, SGA score and body weight. The DFA extracted MAMC, glucose level and NRI scores were variables of importance for the prediction of whether admitted patients would be classified as well or malnourished.

CONCLUSION: SGA showed higher sensitivity to predictor factors. Assessment of nutritional status requires a multidimensional approach, which includes different clinical indices and various nutritional parameters.

Keywords: Nutritional status, Subjective global assessment, Nutritional risk index, Comparison