Accuracy of subjective global assessment versus objective determination for assessment of nutritional status in cancer patients: A single-center observational study

Abstract

Introduction: The study's objective was to determine the accuracy of the Global Subjective Assessment (GSA) versus the Objective Assessment (OA) of the nutritional status of cancer patients.

Methodology: This observational study was carried out at the IESS Hospital in Santo Domingo-Ecuador from January to May 2018. Patients with cancer of any organ were included, and the variables were age, sex, and type of neoplasia. OA uses body mass index (BMI), % body fat, upper arm circumference, upper arm muscle circumference, serum albumin, and hemoglobin. The GSA test was performed.

Results: A total of 114 patients were analyzed, 59 men (51%). The average age was 69 ± 13.6 years in men and 56 ± 15.7 years in women. Within the GSA-A (Well Nourished) category, 62.7% are men, and 69.1% are women. In the GSA-B&C categories (moderate and severe malnutrition), 37.3% of men and 30.9% of women had malnutrition. The BMI was 28.8 Kg/m² in GSA-A and 24.2 in GSA-B&C, P<0.0001. The % body fat was 31.3% in GSA-A and 24.7% in GSA- B&C (P=0.0047). Arm circumference in GSA-A was 30.3 cm, and in GSA-B&C, it was 25.97 cm (P<0.0001). Sensitivity (S) of 12.8% of the GSA for body mass index, specificity (Sp) 100%; accuracy (A) 70.2%; GSA for % body fat S: 41.0%, Sp: 88%, A: 71.9%. GSA for arm circumference S: 71.8%, Sp: 65.3%, A: 67.5%.

Conclusion: The application of the subjective global assessment test has a low sensitivity for nutritional diagnosis; the accuracy of the test is 70% for the diagnosis of BMI and percentage of body fat and 65% for arm circumference.