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The Subjective Global Assessment Predicts In-Hospital Mortality Better than Other Nutrition-Related Risk Indexes in Noncritically Ill Inpatients Who Receive Total Parenteral Nutrition in Spain (Prospective Multicenter Study)

Published:August 22, 2013DOI:https://doi.org/10.1016/j.jand.2013.05.027

      Abstract

      Malnutrition in hospitalized patients is associated with an increased risk of death and complications. The purpose of this study was to determine which nutrition-related risk index predicts mortality better in patients receiving total parenteral nutrition. This prospective, multicenter study involved noncritically ill patients who were prescribed total parenteral nutrition. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index, Geriatric Nutritional Risk Index, body mass index, albumin and prealbumin, as well as in-hospital mortality, length of stay, and infectious complications. Of the 605 patients included in the study, 18.8% developed infectious complications and 9.6% died in the hospital. SGA, albumin, Nutritional Risk Index and Geriatric Nutritional Risk Index were associated with longer hospital stay. Prealbumin levels were associated with infectious complications. Multiple logistic regression analysis showed (after adjustment for age, sex, C-reactive protein levels, mean blood glucose levels, use of corticoids, prior comorbidity, carbohydrates infused, diagnosis, and infectious complications) that the SGA, Geriatric Nutritional Risk Index, body mass index, albumin, and prealbumin were associated with an increased risk for in-hospital mortality. SGA was the tool that best predicted mortality and adequately discriminated the values of the other nutrition-related risk indexes studied. The SGA is a clinically effective and simple tool for nutrition assessment in noncritically ill patients receiving total parenteral nutrition and detects the risk of inpatient mortality better than others.

      Keywords

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      Biography

      G. Olveira is a consultant, Endocrinology and Nutrition Service, Instituto de Biomedicina de Málaga (IBIMA), Carlos Haya University Hospital, Malaga, Spain, and a senior researcher, CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases, Instituto de Salud Carlos III, Madrid, Spain.

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      M. José Tapia is a consultant, Endocrinology and Nutrition Service, Instituto de Biomedicina de Málaga (IBIMA), Carlos Haya University Hospital, Malaga, Spain.

      Biography

      J. Ocón is a consultant, Endocrinology and Nutrition Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.

      Biography

      C. Cabrejas-Gómez is a consultant, Endocrinology and Nutrition Service. Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.

      Biography

      M. D. Ballesteros-Pomar is a consultant, Endocrinology and Nutrition Service, Complejo Asistencial Universitario de León, León, Spain.

      Biography

      A. Vidal-Casariego is a consultant, Endocrinology and Nutrition Service, Complejo Asistencial Universitario de León, León, Spain.

      Biography

      C. Arraiza-Irigoyen is a consultant, Endocrinology and Nutrition Service, Complejo Hospitalario de Jaén, Jaén, Spain.

      Biography

      J. Olivares is a consultant, Endocrinology and Nutrition Service, Hospital Son Llàtzer, Palma de Mallorca, Islas Baleares, Spain.

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      M. C. Conde-García is a consultant, Endocrinology and Nutrition Service, Hospital General Mancha Centro, Alcázar de San Juan, Ciudad-Real, Spain.

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      Á. García-Manzanares is a consultant, Endocrinology and Nutrition Service, Hospital General Mancha Centro, Alcázar de San Juan, Ciudad-Real, Spain.

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      F. Botella-Romero is chief of service, Endocrinology and Nutrition Service, Complejo Hospitalario, Universitario de Albacete, Albacete, Spain.

      Biography

      R. P. Quilez-Toboso is a consultant, Endocrinology and Nutrition Service, Complejo Hospitalario, Universitario de Albacete, Albacete, Spain.

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      L. Cabrerizo is chief of unit, Endocrinology and Nutrition Service, Hospital Clínico San Carlos, Madrid, Spain.

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      M. Ángel Rubio is chief of unit, Endocrinology and Nutrition Service, Hospital Clínico San Carlos, Madrid, Spain.

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      L. Chicharro is a consultant, Nutritional Support Unit, University Hospital Vall d'Hebron, Barcelona, Spain.

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      R. Burgos is chief of service, Nutritional Support Unit, University Hospital Vall d'Hebron, Barcelona, Spain.

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      P. Pujante is a consultant, Endocrinology and Nutrition Service, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.

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      M. Ferrer is a consultant, Endocrinology and Nutrition Service, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.

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      A. Zugasti is a consultant, Clinical Nutrition Unit, Complejo Hospitalario de Navarra, Navarra, Spain.

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      L. Manjón is a consultant, Endocrinology and Nutrition Service, Hospital de Cabueñes, Gijón, Asturias, Spain.

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      M. Diéguez is a consultant, Endocrinology and Nutrition Service, Hospital de Cabueñes, Gijón, Asturias, Spain.

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      C. Aragón-Valera is a consultant, Endocrinology and Nutrition Service, Fundación Jiménez Díaz, Madrid, Spain.

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      A. Rovira is chief of service, Endocrinology and Nutrition Service, Fundación Jiménez Díaz, Madrid, Spain.

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      M. C. Tous is a consultant, Endocrinology and Nutrition Service, Hospital Universitario Virgen del Rocio, Sevilla, Spain.