Subjective global nutritional assessment in critically ill children

JPEN J Parenter Enteral Nutr. 2013 Sep;37(5):659-66. doi: 10.1177/0148607112452000. Epub 2012 Jun 22.

Abstract

Background: Underweight children admitted to the pediatric intensive care unit (PICU) have a higher risk of mortality than normal-weight children. The authors hypothesized that subjective global nutrition assessment (SGNA) could identify malnutrition in the PICU and predict nutrition-associated morbidities.

Methods: The authors prospectively evaluated the nutrition status of 150 children (aged 31 days to 5 years) admitted to the PICU with the use of SGNA and commonly used objective anthropometric and laboratory measurements. Each child was administered the SGNA by a dietitian while anthropometric measurements were performed by an independent assessor. To test interrater reproducibility, 76 children had SGNA performed by another dietitian. Occurrence of nutrition-associated complications was documented for 30 days after admission.

Results: SGNA ratings of well nourished, moderately malnourished, or severely malnourished demonstrated moderate to strong correlation with several standard anthropometric measurements (P < .05). The laboratory markers did not demonstrate any correlation with SGNA. Interrater agreement showed moderate reliability (κ = 0.671). Length of stay, pediatric logistic organ dysfunction, and Pediatric Risk of Mortality III were not significantly different across the groups and did not correlate with SGNA.

Keywords: critical care; malnutrition; validity.

MeSH terms

  • Anthropometry
  • Child, Preschool
  • Critical Illness / epidemiology*
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Intensive Care Units, Pediatric
  • Length of Stay
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / epidemiology*
  • Nutrition Assessment*
  • Nutritional Status
  • Prospective Studies
  • Reproducibility of Results
  • Wisconsin / epidemiology