Subjective global assessment. Part 2. Review of its adaptations and utilization in different clinical specialties

Abstract

Background - The subjective global assessment is a clinical method for nutritional assessment that considers not only body composition alterations but also changes in physiological function. The method is simple, inexpensive and non-invasive, and it can be performed at bedside. Although the subjective global assessment was developed to assess surgical patients, many studies have showed its use in other clinical situations, evaluating patients with renal failure patients, cancer, liver diseases, as well as elderly and HIV-infected patients. Aim - To review the use of subjective global assessment in other clinical situations and intervention studies. Methods - It was performed a systematic review in MEDLINE, using subjective global assessment as search term and the most relevant papers were selected. Results - It was found the subjective global assessment modifications to be applied in renal failure patients, cancer and liver diseases, with good results. In patients with cancer, the subjective global assessment has been used to identify patients who are at higher nutritional risk and would need an aggressive nutritional support. Few intervention studies in surgical patients used subjective global assessment to identify nutritional risk patients. Conclusions - The subjective global assessment has been a good option in nutritional assessment in surgical patients and some modifications have been suggested to adjust the method to other clinical situations. The observer experience is of extreme importance, since the precision of the method depends on it.