Validation of the SGA nutritional screening tool among surgical patients in black lion specialized hospital Addis Ababa, Ethiopia
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Date
2018-06
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Addis Ababa Universty
Abstract
Background: Malnutrition is common in hospital and occurs in more than 50% of hospitalized patients. It is one of the most important factors which determine the clinical outcomes of patients. Therefore, most of the developed countries has made tremendous progress in screening for malnutrition at admission and giving nutritional support for those that required. The burden of malnutrition hardly ravages in developing countries especially in Africa and talking about it tend to refer only to children forgetting adults. Thereby, medical awareness is insufficient and in Ethiopia as well as in several countries, screening hospitalized patients for malnutrition is not a routine part of treatment. If so, some hospitals still used certain common anthropometric and biological markers. First step of treating is screening and screened required a validated screening tool which has not been properly addressed.
Objective: To validate subjective global assessment (SGA) against full nutritional assessment (FNA) and to assess its reliability among adult surgical patients for effective integration in daily surgical wards practice in Black Lion Specialized Hospital.
Methods: The study design was a facility based, cross-sectional concurrent validation design. The study was conducted at Black Lion Specialized Hospital in surgical department. Data were collected from February-April 2018 and one hundred hospitalized patients aged ≥18 years were screened randomly using systematic sampling. Concurrent validity was assessed through sensitivity, specificity, positive predictive value and negative predictive value of the SGA comparing to FNA considered as gold standard. Its reliability assessed by cronbach’s alpha. SPSS version 21 was used for analysis.
Results: A total of 100 patients aged ≥18 years participated in this study and fifty two percent (52%) were male. Among all abdominal operations performed, fifty nine of the patients (59%) were diagnosed for gastrointestinal cancer and 41 patients (41%) with benign or acute GI disease. Considering FNA as the gold standard, the sensitivity and specificity of SGA were 98.3% and 73.2% respectively. The internal consistency of SGA questionnaire measured using Cronbach’s α coefficient gave a value of α =0.805.
Conclusion and Recommendation: In this study, SGA showed a high level of sensitivity with a specificity >70%. The reliability of the SGA questionnaire is acceptable and showed an agreement with FNA. Therefore SGA is applicable in Ethiopian settings. However, to overcome self-weight report issue, further research on modification of the SGA regarding weight change item might be needed for cultural adaptation.
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Keywords
Malnutrition,subjective global assessment