TITLE:
Subjective Global Assessment as a Pre-Operative Nutrition Status Screening Tool for Head and Neck Cancer Patients of a Tertiary Health Care Setting
AUTHORS:
Snany Surendran, Uma V. Sankar, Santhoshkumar Nochikkattil, Reena Cheekapravan, Narayanankutty Warrier, Sajith Babu
KEYWORDS:
Subjective Global Assessment, Nutrition Assessment, Head and Neck Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.13 No.8,
August
26,
2022
ABSTRACT: Introduction: In India, 57% of patients with head and neck cancers are documented
with nutritional compromise. Active nutritional support has been shown to improve outcomes and reduce the cost of
treatment in severely malnourished patients. The assessment of
nutritional status should be a priority when initiating medical nutrition
therapy. We evaluated the agreement between Subjective and Objective evaluation
of pre-operative nutrition status of head and
neck cancer patients in a tertiary cancer centre. Methods: Two
hundred and thirty seven head and neck cancer patients who underwent surgery
were eligible. The patients included both males (147) and females (90) with age
varying between 23 - 88 years. All patients were screened for pre-operative
nutrition status objectively as well as subjectively. The association of
pre-operative SGA scores (A, B and C) subjectively, and PNS score (0, 1, 2)
objectively were tested for statistical significance. Results: The
cancer sites included tongue in 82, buccal mucosa in 30, thyroid in 28, alveolus in 18, glottis in 10, RMT in
10, nasal cavity in 9, FOM in 8. The pre-operative nutrition status based on
subjective scores are A in 156 (65.8%), B in 75 (32%) and C in 6 (2.5%). The
objective parameters obtained on the basis of BMI, % weight loss, PNI and S. albumin values are PNS 0 in 161 (67.9%), PNS 1 in 71
(30%) and PNS 2 in 5 (2.1%) patients. As the kappa coefficient p-0.56, there is
moderate agreement between the pre-operative nutrition status subjectively as well as objectively. Conclusion:
Subjective global assessment is a simple and inexpensive way to screen
the pre-operative nutrition status when compared to the other objective
assessment tool. SGA has moderate agreement with expensive and complicated
objective assessment tools. So it can be a reliable tool for assessing the
pre-operative nutrition status.