SUBJECTIVE GLOBAL ASSESSMENT AND THE ROYAL FREE HOSPITAL GLOBAL EVALUATION IN CHRONIC LIVER DISEASE

Abstract

Introduction: Malnutrition in patients with chronic liver disease is common; its prognostic value for life being indisputable due to its impact on morbidity and mortality; However, to date there is no ideal method for nutritional assessment in this pathology. Objective: to compare the subjective global assessment (VGS) and the Royal Free Hospital Global Assessment (RFH-VG) as a nutritional assessment tool in adults with liver disease. Methods: Cross-sectional, field and correlational study, the non-probabilistic random sample was made up of 65 subjects, to whom both nutritional evaluation methods were applied. For VGS, the Detski form was used and for the evaluation with the Royal Free Hospital the Morgan algorithm was used; Results: In the VGS, 52 subjects presented malnutrition (55.4% reflected moderate malnutrition and 24.6% severe malnutrition); while in the RFH-VG it was found that 47 subjects presented malnutrition (46.2% moderate malnutrition and 26.2% severe malnutrition). Regarding gender, in the VGS, women predominated in moderate malnutrition in both methods; and in the RFH-VG, men predominated in severe malnutrition. The VGS presented a sensitivity of 97%, specificity of 60%; AUC 0.80; (95% CI 0.66 to 0.97), RFH-VG had a sensitivity of 95%, specificity 84% AUC 0.89 (95% CI 0.79 to 1.00). Conclusions: The VGS and RFH-VG methods demonstrated a sensitivity greater than 90%; However, the RFH-VG seems to better classify patients with normal nutritional status, reflecting a greater specificity in relation to that observed in the VGS.Introduction: Malnutrition in patients with chronic liver disease is common; its prognostic value for life being indisputable due to its impact on morbidity and mortality; However, to date there is no ideal method for nutritional assessment in this pathology. Objective: to compare the subjective global assessment (VGS) and the Royal Free Hospital Global Assessment (RFH-VG) as a nutritional assessment tool in adults with liver disease. Methods: Cross-sectional, field and correlational study, the non-probabilistic random sample was made up of 65 subjects, to whom both nutritional evaluation methods were applied. For VGS, the Detski form was used and for the evaluation with the Royal Free Hospital the Morgan algorithm was used; Results: In the VGS, 52 subjects presented malnutrition (55.4% reflected moderate malnutrition and 24.6% severe malnutrition); while in the RFH-VG it was found that 47 subjects presented malnutrition (46.2% moderate malnutrition and 26.2% severe malnutrition). Regarding gender, in the VGS, women predominated in moderate malnutrition in both methods; and in the RFH-VG, men predominated in severe malnutrition. The VGS presented a sensitivity of 97%, specificity of 60%; AUC 0.80; (95% CI 0.66 to 0.97), RFH-VG had a sensitivity of 95%, specificity 84% AUC 0.89 (95% CI 0.79 to 1.00). Conclusions: The VGS and RFH-VG methods demonstrated a sensitivity greater than 90%; However, the RFH-VG seems to better classify patients with normal nutritional status, reflecting a greater specificity in relation to that observed in the VGS.