Malnutrition screening and assessment in the cancer care ambulatory setting: Mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria

Lynette M. De Groot; Gahee Lee; Antoinette Ackerie; Barbara S. van der Meij

doi:10.3390/nu12082287

Malnutrition screening and assessment in the cancer care ambulatory setting: Mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria

Lynette M. De Groot
, Gahee Lee
, Antoinette Ackerie
, Barbara S. van der Meij^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Research › peer-review

163 Citations (Scopus)

251 Downloads (Pure)

Abstract

Background:

A valid malnutrition screening tool (MST) is essential to provide timely nutrition support in ambulatory cancer care settings. The aim of this study is to investigate the validity of the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) and the new Global Leadership Initiative on Malnutrition (GLIM) criteria as compared to the reference standard, the Patient-Generated Subjective Global Assessment (PG-SGA).

Methods:

Cross-sectional observational study including 246 adult ambulatory patients with cancer receiving in-chair intravenous treatment at a cancer care centre in Australia. Anthropometrics, handgrip strength and patient descriptive data were assessed. Nutritional risk was identified using MST and PG-SGA SF, nutritional status using PG-SGA and GLIM. Sensitivity (Se), specificity (Sp), positive and negative predictive values and kappa (k) were analysed. Associations between malnutrition and 1-year mortality were investigated by Cox survival analyses.

Results:

A PG-SGA SF cut-off score ≥5 had the highest agreement when compared with the PG-SGA (Se: 89%, Sp: 80%, k = 0.49, moderate agreement). Malnutrition risk (PG-SGA SF ≥ 5) was 31% vs. 24% (MST). For malnutrition according to GLIM, the Se was 76% and Sp was 73% (k = 0.32, fair agreement) when compared to PG-SGA. The addition of handgrip strength to PG-SGA SF or GLIM did not improve Se, Sp or agreement. Of 100 patients who provided feedback, 97% of patients found the PG-SGA SF questions easy to understand, and 81% reported that it did not take too long to complete. PG-SGA SF ≥ 5 and severe malnutrition by GLIM were associated with 1-year mortality risk.

Conclusions:

The PG-SGA SF and GLIM criteria are accurate, sensitive and specific malnutrition screening and assessment tools in the ambulatory cancer care setting. The addition of handgrip strength tests did not improve the recognition of malnutrition or mortality risk.

Original language	English
Article number	2287
Pages (from-to)	1-13
Number of pages	13
Journal	Nutrients
Volume	12
Issue number	8
DOIs	https://doi.org/10.3390/nu12082287
Publication status	Published - Aug 2020

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 2 Zero Hunger
SDG 3 Good Health and Well-being

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Research by Master of Nutrition and Dietetic Practice Students
Isenring, E. (Supervisor), Marshall, S. (Supervisor), Reidlinger, D. (Project Lead), Kelly, J. (Supervisor), Cox, G. (Supervisor), Van der Meij, B. (Supervisor), MacKenzie-Shalders, K. (Supervisor), Mayr, H. (Supervisor), Utter, J. (Associate Professor), Dahl, C. (Masters by Coursework Student), Crichton, M. (Masters by Coursework Student), O'Bryan, K. R. (Masters by Coursework Student), Norris, R. (Masters by Coursework Student), Fahey, M. (Masters by Coursework Student), Davidson, A. (Masters by Coursework Student), Naranjo, A. (Masters by Coursework Student), Mahoney, S. (Masters by Coursework Student), Eberhardt, F. (Masters by Coursework Student), Dalwood, P. (Masters by Coursework Student), Lopez, E. (Masters by Coursework Student), Hofto, S. (Masters by Coursework Student), Innerarity, C. (Masters by Coursework Student), So, D. (Masters by Coursework Student), McIntosh, A. (Masters by Coursework Student), Gadd, N. (Masters by Coursework Student), Chan, H. C. (Masters by Coursework Student), Lan, X. (Masters by Coursework Student), Fei, X. (Masters by Coursework Student), Kostjasyn, S. (Masters by Coursework Student), Adhyaru, P. (Masters by Coursework Student), Giang, J. (Masters by Coursework Student), Leung, E. L. Y. (Masters by Coursework Student), Strike, K. (Project Roles), Pearcy, J. (Masters by Coursework Student), Somani, A. (Masters by Coursework Student), Wright, C. (Masters by Coursework Student), Matthews, C. (Masters by Coursework Student), Lee, G. (Masters by Coursework Student), Tang, X. (Associate Investigator) & Eso, A. (Associate Investigator)
1/01/14 → 31/12/27
Project: Research
Oncology Nutrition Research
Isenring, E. (Project Lead), Marshall, S. (Senior Research Fellow), Van der Meij, B. (Senior Research Fellow), Rigby, R. (Associate Investigator), Teleni, L. (HDR Student), Crichton, M. (HDR Student) & Tang, X. (Admin)
1/01/14 → …
Project: Research

Cite this

@article{e1a1c3311b6a482b997e400b55ec47bb,

title = "Malnutrition screening and assessment in the cancer care ambulatory setting: Mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria",

abstract = "Background: A valid malnutrition screening tool (MST) is essential to provide timely nutrition support in ambulatory cancer care settings. The aim of this study is to investigate the validity of the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) and the new Global Leadership Initiative on Malnutrition (GLIM) criteria as compared to the reference standard, the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: Cross-sectional observational study including 246 adult ambulatory patients with cancer receiving in-chair intravenous treatment at a cancer care centre in Australia. Anthropometrics, handgrip strength and patient descriptive data were assessed. Nutritional risk was identified using MST and PG-SGA SF, nutritional status using PG-SGA and GLIM. Sensitivity (Se), specificity (Sp), positive and negative predictive values and kappa (k) were analysed. Associations between malnutrition and 1-year mortality were investigated by Cox survival analyses. Results: A PG-SGA SF cut-off score ≥5 had the highest agreement when compared with the PG-SGA (Se: 89\%, Sp: 80\%, k = 0.49, moderate agreement). Malnutrition risk (PG-SGA SF ≥ 5) was 31\% vs. 24\% (MST). For malnutrition according to GLIM, the Se was 76\% and Sp was 73\% (k = 0.32, fair agreement) when compared to PG-SGA. The addition of handgrip strength to PG-SGA SF or GLIM did not improve Se, Sp or agreement. Of 100 patients who provided feedback, 97\% of patients found the PG-SGA SF questions easy to understand, and 81\% reported that it did not take too long to complete. PG-SGA SF ≥ 5 and severe malnutrition by GLIM were associated with 1-year mortality risk. Conclusions: The PG-SGA SF and GLIM criteria are accurate, sensitive and specific malnutrition screening and assessment tools in the ambulatory cancer care setting. The addition of handgrip strength tests did not improve the recognition of malnutrition or mortality risk.",

author = "\{De Groot\}, \{Lynette M.\} and Gahee Lee and Antoinette Ackerie and \{van der Meij\}, \{Barbara S.\}",

year = "2020",

month = aug,

doi = "10.3390/nu12082287",

language = "English",

volume = "12",

pages = "1--13",

journal = "Nutrients",

issn = "2072-6643",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "8",

}

Malnutrition screening and assessment in the cancer care ambulatory setting: Mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria. / De Groot, Lynette M.; Lee, Gahee; Ackerie, Antoinette et al.
In: Nutrients, Vol. 12, No. 8, 2287, 08.2020, p. 1-13.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - Malnutrition screening and assessment in the cancer care ambulatory setting: Mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria

AU - De Groot, Lynette M.

AU - Lee, Gahee

AU - Ackerie, Antoinette

AU - van der Meij, Barbara S.

PY - 2020/8

Y1 - 2020/8

N2 - Background: A valid malnutrition screening tool (MST) is essential to provide timely nutrition support in ambulatory cancer care settings. The aim of this study is to investigate the validity of the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) and the new Global Leadership Initiative on Malnutrition (GLIM) criteria as compared to the reference standard, the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: Cross-sectional observational study including 246 adult ambulatory patients with cancer receiving in-chair intravenous treatment at a cancer care centre in Australia. Anthropometrics, handgrip strength and patient descriptive data were assessed. Nutritional risk was identified using MST and PG-SGA SF, nutritional status using PG-SGA and GLIM. Sensitivity (Se), specificity (Sp), positive and negative predictive values and kappa (k) were analysed. Associations between malnutrition and 1-year mortality were investigated by Cox survival analyses. Results: A PG-SGA SF cut-off score ≥5 had the highest agreement when compared with the PG-SGA (Se: 89%, Sp: 80%, k = 0.49, moderate agreement). Malnutrition risk (PG-SGA SF ≥ 5) was 31% vs. 24% (MST). For malnutrition according to GLIM, the Se was 76% and Sp was 73% (k = 0.32, fair agreement) when compared to PG-SGA. The addition of handgrip strength to PG-SGA SF or GLIM did not improve Se, Sp or agreement. Of 100 patients who provided feedback, 97% of patients found the PG-SGA SF questions easy to understand, and 81% reported that it did not take too long to complete. PG-SGA SF ≥ 5 and severe malnutrition by GLIM were associated with 1-year mortality risk. Conclusions: The PG-SGA SF and GLIM criteria are accurate, sensitive and specific malnutrition screening and assessment tools in the ambulatory cancer care setting. The addition of handgrip strength tests did not improve the recognition of malnutrition or mortality risk.

AB - Background: A valid malnutrition screening tool (MST) is essential to provide timely nutrition support in ambulatory cancer care settings. The aim of this study is to investigate the validity of the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) and the new Global Leadership Initiative on Malnutrition (GLIM) criteria as compared to the reference standard, the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: Cross-sectional observational study including 246 adult ambulatory patients with cancer receiving in-chair intravenous treatment at a cancer care centre in Australia. Anthropometrics, handgrip strength and patient descriptive data were assessed. Nutritional risk was identified using MST and PG-SGA SF, nutritional status using PG-SGA and GLIM. Sensitivity (Se), specificity (Sp), positive and negative predictive values and kappa (k) were analysed. Associations between malnutrition and 1-year mortality were investigated by Cox survival analyses. Results: A PG-SGA SF cut-off score ≥5 had the highest agreement when compared with the PG-SGA (Se: 89%, Sp: 80%, k = 0.49, moderate agreement). Malnutrition risk (PG-SGA SF ≥ 5) was 31% vs. 24% (MST). For malnutrition according to GLIM, the Se was 76% and Sp was 73% (k = 0.32, fair agreement) when compared to PG-SGA. The addition of handgrip strength to PG-SGA SF or GLIM did not improve Se, Sp or agreement. Of 100 patients who provided feedback, 97% of patients found the PG-SGA SF questions easy to understand, and 81% reported that it did not take too long to complete. PG-SGA SF ≥ 5 and severe malnutrition by GLIM were associated with 1-year mortality risk. Conclusions: The PG-SGA SF and GLIM criteria are accurate, sensitive and specific malnutrition screening and assessment tools in the ambulatory cancer care setting. The addition of handgrip strength tests did not improve the recognition of malnutrition or mortality risk.

UR - https://www.scopus.com/pages/publications/85088975780

U2 - 10.3390/nu12082287

DO - 10.3390/nu12082287

M3 - Article

C2 - 32751724

AN - SCOPUS:85088975780

SN - 2072-6643

VL - 12

SP - 1

EP - 13

JO - Nutrients

JF - Nutrients

IS - 8

M1 - 2287

ER -

Malnutrition screening and assessment in the cancer care ambulatory setting: Mortality predictability and validity of the patient-generated subjective global assessment short form (PG-SGA SF) and the GLIM criteria

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