Subjective Global Assessment: Evaluating Nutritional Status

Posted on Dec 14, 2024 in Medicine & Health

Subjective Global Assessment

• A) Anthropometry
• B) Biochemical data
• C) Physical examination
• D) Dietary assessment

• Changes in weight and height
• Changes in food intake
• Gastrointestinal symptoms > 2 weeks
• Functional capacity
• Disease and its relation to nutritional needs

The Physical Examination Should Consider:

• Loss of subcutaneous fat
• Muscle mass
• Skin lesions
• Clinical signs of nutrient deficiency and edema

The Clinical History Should Consider:

• Weight change
• Intake
• Gastrointestinal symptoms persisting for more than 2 weeks, such as nausea, vomiting, diarrhea, etc.
• Functional impairment

Subjective Global Assessment Classifies Patients In:

• A) Well-nourished
• B) Mild or moderate malnutrition
• C) Severely malnourished

• Advantages: Effective, low cost.
• Disadvantages: Depends on the observer. There are no anthropometric or biochemical assessments. It takes a trained evaluator.

Examine the Reserves of Fat and Muscle:

• Around the eye socket is a good deposit of fat
• In well-nourished individuals, fat deposits appear as slight bulges
• In individuals with DN, there is depression in the eye or obscured under-eye area.

Muscular Sign

• A depression in the temple is a characteristic sign of muscle loss in malnourished patients.
• In well-nourished people, the muscle that goes from the eye socket to the temple is visible along it.
• If the area has a sleek look, without sinking, without loss of muscle mass, it is classified as well-nourished.
• If depression also can be called “flowerpots wear.”
• Another good deposit of fat is the arm.
• Determining the amount of fat in the biceps and triceps can help define the nutritional status of the patient.
• If the patient has lost in almost all areas, they are classified as severely malnourished.
• If the patient presents only fat loss and muscle in some areas, they are classified as mild or moderate malnutrition.
• If no deterioration in any area, the individual is classified as well-nourished.
• In malnourished individuals, the fingertips are almost united by the absence of fatty tissue.
• In the individual, the fingertips are separated to make the fold

Clinical assessment: Intake, weight changes, gastrointestinal symptoms, and functional impairment.

To Determine Dietary Intake Using the Following Criteria:

• The more important is the reduction in food intake or appetite, the more time will be more severe classification.
• Were classified as mild to moderate malnutrition if significant.
• Severe malnutrition if the intake is almost nil.
• If the patient eats well and no weight change was classified as well-nourished.

Changes in Weight Were Clarified as Follows:

• If weight loss is classified as mild to moderate.
• If weight loss is severe, to be classified as severely malnourished.

Functional Impairment

• It is classified as force or energy lost by the DN.
• Difficulty performing tasks such as walking and getting up shows a risk of malnutrition.
• Should not be confused alterations caused by the disease, amputation, impairment in arthritic joints in the malnourished.

Interpretation of EGS

• DN severe classification is given to patients who have had a fat loss and muscle importantly, a continuous loss of weight, lost 10% of total weight in 6 months or a significant intake restriction.
• The classification of mild or moderate DN is given to patients with loss of 5-10% of total weight in 6 months, with slight loss of fat and muscle and a reduction in mild or moderate intake may or may not have symptoms.