Vajira Surgical Nutritional Screening Tool Compared with Subjective Global Assessment Test (SGA)

Abstract

Vajira Surgical Nutritional Screening Tool Compared with Subjective Global Assessment Test (SGA)

Kamonrut Pibul MD, FRCST, FICS

Anan Manomaipiboon MD, MSc, FRCST, FICS

Suphakarn Techapongsatorn MD, MSc, FRCST, FICS

Surasee Boonyavanich MD

Thanaporn Tosanguanrungruang RN

Sunanta Vitayaudom RN

Department of Surgery, BMA Medical College and Vajira Hospital

Objective: To evaluate the diagnostic performances of the Vajira surgical nutritional screening tool compared with subjective global assessment (SGA) test.

Study design: Descriptive study (diagnostic test).

Subjects: A total of 200 patients admitted in the general surgical units, BMA Medical College and Vajira Hospital between January and June 2008.

Methods: The nutritional status was evaluated by the Vajira surgical nutritional screening tool in terms of score ranging from 0-11 and SGA test. Age, sex and diseases were also recorded.

Main outcome measures: sensitivity, specificity, positive predictive value, negative predictive value and 95% confidence interval (95% CI).

Results: The mean age of the patients was 50.5 + 11.5 years. About 36.0% of them were male while 64.0% were female. Hepatobiliary diseases were found in 20.0% while large bowel malignancy was found in 16.0%. Prevalence of malnutrition diagnosed from SGA test was 44.5% including 35.0% of mild-moderate malnutrition and 9.5% of severe malnutrition. The score from Vajira surgical nutritional screening tool at cutoff point > 4 had a sensitivity of 83.2% (95% CI, 78.0-88.3%), specificity of 87.4% (95% CI, 82.8-92.0%), positive predictive value and negative predictive value of 84.1% (95% CI, 79.0-89.2%) and 86.6% (95% CI, 81.9-91.3%) respectively to diagnose malnutrition compared to SGA test.

Conclusion: The Vajira surgical nutritional screening tool is an effective tool with high sensitivity and specificity for identifying malnutrition in surgical patients.

Key words: Vajira Surgical Nutritional Screening test, Subjective Global Assessment, SGA, malnutrition, surgical patients

Vajira Med J 2009 ; 54 : 25 - 32