Subjective global assessment of nutritional status - A systematic review of the literature

Background & aims: Subjective Global Assessment (SGA) is a nutritional assessment tool widely used in hospital clinical practice, even though it is not exempted of limitations in relation to its use. This systematic revieW intended to update knowledge on the performance of SGA as a method for the assessment of the nutritional status of hospitalized adults. Methods: PubMed data base was consulted, using the search term "subjective global assessment". Studies published in English, Portuguese or Spanish, between 2002 and 2012 were selected, excluding those not found in full, letters to the editor, pilot studies, narrative reviews, studies with n < 30, studies with population younger than 18 years of age, research with non-hospitalized populations or those which used a modified version of the SGA. Results: Of 454 eligible studies, 110 presented eligibility criteria. After applying the exclusion criteria, 21 studies were selected, 6 with surgical patients, 7 with clinical patients, and 8 with both. Most studies demonstrated SGA performance similar or better than the usual assessment methods for nutritional status, such as anthropometry and laboratory data, but the same result was not found when comparing SGA and nutritional screening methods. Conclusions: Recently published literature demonstrates SGA as a valid tool for the nutritional diagnosis of hospitalized clinical and surgical patients, and point to a potential superiority of nutritional screening methods in the early detection of malnutrition. (C) 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.