M CHAN1,2,3, S BAHCECI1, A WILSON4
1The St. George Hospital, Kogarah, NSW; 2University of New South Wales, Kensington, NSW; 3University of Wollongong, Wollongong, NSW; 4The Sutherland Hospital, Caringbah, NSW
Aim: To examine the relationship between the changes (D) of nutrition status scored by Subjective Global Assessment (SGA) and various nutritional parameters.
Background: SGA (7 point scale) is a validated nutrition assessment tool commonly used in the haemodialysis (HD) population and correlates with various clinical parameters to predict outcomes. However, the relationships between the changes (D) of these parameters over time as in routine nutrition monitoring have seldom been examined in the literature.
Methods: Retrospective analysis of routine nutritional assessment record were performed in a cohort of HD patients over a three month period. Data collected were demographics such as age and gender; nutritional parameters including dry body weight (BW), serum albumin (s-alb), haemoglobin (Hb), SGA and hand-grip strength (HGS) which is also a functional capacity measure. Changes (D) and percentage (%) of changes (D) from baseline were examined. Statistical analyses were performed using descriptive statistics and ANOVA.
Results: Ninety-two subjects were studied (male, 59.8%; age, 70.5±12.5 years; diabetic, 54.3%). Prevalence of malnutrition (SGA score B & C) was 34.8% at both month 0 and 3. 24 (26.1%) have improved SGA score (+1), 52 (56.5%) remained stable with no change in SGA score (0) and 16 (17.4%) have deteriorated SGA score (-1). The associated changes for SGA score +1, 0, -1 and D %BW were 0.6±1.3 vs. 0.2±2.5 vs. -1.1±2.5 (p=0.06); D %s-alb were 1.6±10.5 vs. 0±7.7 vs. -6.0±7.9 (p=0.02); D %Hb were -1.0±9.6 vs. 0.8±10.2 vs. -4.9±5.3 (p=0.3); D %HGS were 20.6±38.7 vs 3.3±18.4 vs. -11.2±38.7 (p<0.0001) respectively.
Conclusions: Change of SGA score is positively associated with the change of s-alb and HGS. HGS could be a useful tool for serial nutrition assessment.