SUBJECTIVE GLOBAL ASSESSMENT AND THE ROYAL FREE HOSPITAL GLOBAL EVALUATION IN CHRONIC LIVER DISEASE

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Paola María Valero Cubillán
Mareidys Cecilia Daza
Hazel Barboza Zambrano
Hazel Anderson Vásquez
https://orcid.org/0000-0002-3519-6168

Abstract

Introduction: Malnutrition in patients with chronic liver disease is common; its prognostic value for life being indisputable due to its impact on morbidity and mortality; However, to date there is no ideal method for nutritional assessment in this pathology. Objective: to compare the subjective global assessment (VGS) and the Royal Free Hospital Global Assessment (RFH-VG) as a nutritional assessment tool in adults with liver disease. Methods: Cross-sectional, field and correlational study, the non-probabilistic random sample was made up of 65 subjects, to whom both nutritional evaluation methods were applied. For VGS, the Detski form was used and for the evaluation with the Royal Free Hospital the Morgan algorithm was used; Results: In the VGS, 52 subjects presented malnutrition (55.4% reflected moderate malnutrition and 24.6% severe malnutrition); while in the RFH-VG it was found that 47 subjects presented malnutrition (46.2% moderate malnutrition and 26.2% severe malnutrition). Regarding gender, in the VGS, women predominated in moderate malnutrition in both methods; and in the RFH-VG, men predominated in severe malnutrition. The VGS presented a sensitivity of 97%, specificity of 60%; AUC 0.80; (95% CI 0.66 to 0.97), RFH-VG had a sensitivity of 95%, specificity 84% AUC 0.89 (95% CI 0.79 to 1.00). Conclusions: The VGS and RFH-VG methods demonstrated a sensitivity greater than 90%; However, the RFH-VG seems to better classify patients with normal nutritional status, reflecting a greater specificity in relation to that observed in the VGS.

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Valero Cubillán, P. M., Daza, M. C., Barboza Zambrano, H., & Vásquez, H. A. (2024). SUBJECTIVE GLOBAL ASSESSMENT AND THE ROYAL FREE HOSPITAL GLOBAL EVALUATION IN CHRONIC LIVER DISEASE. Enfermería Investiga, 9(1), 13–21. https://doi.org/10.31243/ei.uta.v9i1.2282.2024
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References

Ramos C., Christian O., Santoyo A. Castellanos H., Martínez C., Olarte I., Martínez A. Insuficiencia hepática crónica y hemostasia. Revista Colombiana de Gastroenterología.2017; 32(4): 349-367. DOI: https://doi.org/10.22516/25007440.178

Jia Y, Zhong F, Jiang S, Guo Q, Jin H, Wang F, Li M, Wang L, Chen A, Zhang F, Shao J, Zheng S. Periostin in chronic liver diseases: Current research and future perspectives. Life Sci. 2019;226:91-97. DOI: https://doi.org/10.1016/j.lfs.2019.04.021

Sharma A, Nagalli S. Chronic Liver Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK554597/.

Dara L, Ji C, Kaplowitz N. The contribution of endoplasmic reticulum stress to liver diseases. Hepatology. 2011 May;53(5):1752-1763. DOI: https://doi.org/10.1002/hep.24279.

Aceves-Martins M. Cuidado nutricional de pacientes con cirrosis hepática. Nutr. Hosp. 2014; 29(2): 246-258. DOI: https://dx.doi.org/10.3305/nh.2014.29.2.7024.

Velázquez Abente S, Girala Salomón M. Etiología, estadio y complicaciones de la cirrosis hepática en un hospital de referencia en Paraguay. Rev. virtual Soc. Parag. Med. Int. 2018; 5(2): 53-61. DOI: https://doi.org/10.18004/rvspmi/2312-3893/2018.05(02)53-061

Lebroc Perez D, Reina Alfonso BE, Camacho Assef JA, Masip Ramirez M. Caracterización clínica de los pacientes con cirrosis hepática en el Hospital Provincial Docente “Dr. Antonio Luaces Iraola”.. Mediciego. 2011;17(2):1-8. Disponible en: https://www.medigraphic.com/pdfs/mediciego/mdc-2011/mdc112f.pdf

Organización Mundial de la Salud. Estrategia mundial del sector de la salud contra las hepatitis víricas, 2016-2021. Hacia el fin de las hepatitis víricas. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/250578/WHO-HIV-2016.06-spa.pdf

Organización Mundial de la salud. Hepatitis C. 2020. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/hepatitis-c

Pimpin L, Cortez-Pinto H, Negro F, Corbould E, Lazarus JV, Webber L, Sheron N; EASL HEPAHEALTH Steering Committee. Burden of liver disease in Europe: Epidemiology and analysis of risk factors to identify prevention policies. J Hepatol. 2018;69(3):718-735. DOI: http://dx.doi.org/10.1016/j.jhep.2018.05.011.

Vildózola Gonzales H. Etiología y mecanismos de desnutrición en el paciente cirrótico. An. Fac. med. 2020; 81(2): 234-241. DOI: http://dx.doi.org/10.15381/anales.v81i2.18404.

Nishikawa H, Osaki Y. Liver Cirrhosis: Evaluation, Nutritional Status, and Prognosis. Mediators Inflamm. 2015; 2015:872152. DOI: http://dx.doi.org/10.1155/2015/872152.

Hepburn C, von Roenn N. Nutrition in Liver Disease - A Review. Curr Gastroenterol Rep. 2023;25(10):242-249. DOI: http://dx.doi.org/10.1007/s11894-023-00887-4.

Cheung K, Lee SS, Raman M. Prevalence and mechanisms of malnutrition in patients with advanced liver disease, and nutrition management strategies. Clin Gastroenterol Hepatol. 2012;10(2):117-125. DOI: http://dx.doi.org/10.1016/j.cgh.2011.08.016.

Espinosa-Flores AJ, Guzman-Ortiz E, Melendez-Mier G, Ternovoy SK, Bueno-Hernandez N, Roldan-Valadez E. A scoping review of the methods used in patients with liver cirrhosis to assess body composition and their nutritional findings. Eur J Clin Nutr. 2023;77(9):845-854. DOI: http://dx.doi.org/10.1038/s41430-023-01287-7.

Romero Sanquiz G, Anderson Vásquez H E, Lizarzábal de Belloso M. Evaluación antropométrica: Un instrumento útil en pacientes con enfermedad hepática crónica. Gen. 2009; 63(3):163-166. Disponible en: http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0016-35032009000300005&lng=es.

Molfino A, Johnson S, Medici V. The Challenges of Nutritional Assessment in Cirrhosis. Curr Nutr Rep. 2017;6(3):274-280. DOI: http://dx.doi.org/10.1007/s13668-017-0216-8.

Buchard B, Boirie Y, Cassagnes L, Lamblin G, Coilly A, Abergel A. Assessment of Malnutrition, Sarcopenia and Frailty in Patients with Cirrhosis: Which Tools Should We Use in Clinical Practice? Nutrients. 2020;12(1):186. DOI: http://dx.doi.org/10.3390/nu12010186.

European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu; European Association for the Study of the Liver. EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol. 2019;70(1):172-193. DOI: http://dx.doi.org/10.1016/j.jhep.2018.06.024.

Plauth M, Bernal W, Dasarathy S, Merli M, Plank LD, Schütz T, Bischoff SC. ESPEN guideline on clinical nutrition in liver disease. Clin Nutr. 2019;38(2):485-521. DOI: http://dx.doi.org/10.1016/j.clnu.2018.12.022.

Laur C, Davidson B, Keller H. Perceptions on Use of the Subjective Global Assessment Before and After It Became Part of Regular Practice. Nutr Clin Pract. 2019;34(6):906-915. DOI: http://dx.doi.org/10.1002/ncp.10270.

Ravasco P., Anderson H., Mardones F. Métodos de valoración del estado nutricional. Nutr. Hosp. 2010; 25(Suppl 3): 57-66. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-1611201000090 0009&lng=es

Romero Sanquiz G, Anderson Vásquez H E, Altamar D, Espina Taborda A F. Evaluación global subjetiva y antropométrica para el diagnóstico nutricional de pacientes con enfermedad hepática crónica. Gen. 2009; 63(2):

-118. Disponible en: http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0016-35032009000200009&lng=es.

Nunes G, Santos CA, Barosa R, Fonseca C, Barata AT, Fonseca J. Outcome and nutritional assessment of chronic liver disease patients using anthropometry and Subjective Global Assessment. Arq Gastroenterol.

;54(3):225-231. DOI: http://dx.doi.org/10.1590/S0004-2803.201700000-28.

Sharma P, Gupta C, Kumar A, Arora A, Anikhindi SA, Singla V, Bansal N, Jasrotia S. Nutritional assessment and factors affecting dietary intake in patients with cirrhosis: A single-center observational study. Nutrition. 2021; 84: 111099. DOI: http://dx.doi.org/10.1016/j.nut.2020.111099.

Tandon P, Raman M, Mourtzakis M, Merli M. A practical approach to nutritional screening and assessment in cirrhosis. Hepatology. 2017;65(3):1044-1057. DOI: http://dx.doi.org/10.1002/hep.29003.

Gottschall CB, Pereira TG, Rabito EI, Álvares-Da-Silva MR. Nutritional status and dietary intake in non-cirrhotic adult chronic Hepatitis C patients. Arq Gastroenterol. 2015;52(3):204-209. DOI: http://dx.doi.org/10.1590/S0004-28032015000300010

World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. DOI: http://dx.doi.org/10.1001/jama.2013.281053.

Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, Jeejeebhoy KN. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11(1):8-13. DOI: http://dx.doi.org/ 10.1177/014860718701100108.

Morgan MY, Madden AM, Soulsby CT, Morris RW. Derivation and validation of a new global method for assessing nutritional status in patients with cirrhosis. Hepatology. 2006 ;44(4):823-35. DOI: http://dx.doi.org/10.1002/hep.21358.

Lohman TG., Roche AF., Martorell R. Anthropometric standardization reference manual. Champaign, Illinois: Human Kinetic Books. 1988. ISBN 087322 121 4.

De Carvalho L, Parise ER, Samuel D. Factors associated with nutritional status in liver transplant patients who survived the first year after transplantation. J Gastroenterol Hepatol. 2010;25(2):391-396. DOI: http://dx.doi.org/10.1111/j.1440-1746.2009.06033.x.

Campillo B, Richardet JP, Bories PN. Validation of body mass index for the diagnosis of malnutrition in patients with liver cirrhosis. Gastroenterol Clin Biol. 2006; 30 (10): 1137-1143. DOI: http://dx.doi.org/10.1016/s0399-8320(06)73491-1.

Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981;34(11):2540-2545. DOI: http://dx.doi.org/10.1093/ajcn/34.11.2540.

Ferrari M. Estimación de la ingesta por recordatorio de 24 horas. DIAETA. 2013; 31 (143):20-25. Disponible en: http://www.scielo.org.ar/pdf/diaeta/v31n143/v31n143a04.pdf

Instituto Nacional de Nutrición (INN). Tabla de composición de alimentos para uso práctico. Rev.1999. publicación Nª 54. Serie de Cuadernos Azules. Caracas, Venezuela: 1-75. 2001

Plauth M, Cabré E, Riggio O, Assis-Camilo M, Pirlich M, Kondrup J; DGEM (German Society for Nutritional Medicine); Ferenci P, Holm E, Vom Dahl S, Müller MJ, Nolte W; ESPEN (European Society for Parenteral and Enteral Nutrition). ESPEN Guidelines on Enteral Nutrition: Liver disease. Clin Nutr. 2006;25(2):285-294. DOI: http://dx.doi.org/10.1016/j.clnu.2006.01.018.

Bauce G, Moya-Sifontes M. Análisis de la curva ROC en la evaluación de indicadores antropométricos. Rev Digit Postgrado. 2022; 11(1): e333. DOI: http://dx.doi.org/10.37910/RDP.2022.11.1.e333

Shafiee F., Karandish M., Mohammad A. Determining the ability of Subjective Global Assessment (SGA) to diagnosis risk of malnutrition in hospitalized patients. Journal of Research in Medical and Dental Sciences.2017;(5) 2: 48-55 disponible en: https://www.researchgate.net/publication

/318211811_Determining_the_ability_of_Subjective_Global_Assessment_SGA_to_diagnosis_risk_of_malnutrition_in_hospitalized_patients

Taniguchi E, Kawaguchi T, Itou M, Oriishi T, Ibi R, Torii M, Yoshida K, Adachi Y, Otsuka M, Uchida Y, Tanaka S, Takakura M, Sata M. Subjective global assessment is not sufficient to screen patients with defective hepatic metabolism. Nutrition. 2011;27(3):282-286. DOI: http://dx.doi.org/10.1016/j.nut.2009.10.016.

García-Rodríguez MT, López-Calviño B, Piñón-Villar MDC, Otero-Ferreiro A, Suárez-López F, Gómez-Gutiérrez M, Pértega-Díaz S, Seoane-Pillado MT, Pita-Fernández S. Concordance among methods of nutritional assessment in patients included on the waiting list for liver transplantation. J Epidemiol. 2017;27(10):469-475. DOI: http://dx.doi.org/10.1016/j.je.2016.09.011.

Ferreira LG, Anastácio LR, Lima AS, Correia MI. Assessment of nutritional status of patients waiting for liver transplantation. Clin Transplant. 2011;25(2):248-254. DOI: http://dx.doi.org/10.1111/j.1399-0012.2010.01228.x.

Moctezuma-Velazquez C, Ebadi M, Bhanji RA, Stirnimann G, Tandon P, Montano-Loza AJ. Limited performance of subjective global assessment compared to computed tomography-determined sarcopenia in predicting adverse clinical outcomes in patients with cirrhosis. Clin Nutr. 2019;38(6):2696-2703. DOI: http://dx.doi.org/10.1016/j.clnu.2018.11.024.

Bunchorntavakul C, Supanun R, Atsawarungruangkit A. Nutritional Status and its Impact on Clinical Outcomes for Patients Admitted to Hospital with Cirrhosis. J Med Assoc Thai. 2016;99 Suppl 2: S47-55.

El-Mohsen S., Magdy A. Subjective Global Assessment for Patients with Hepatic Cirrhosis, Egypt. International Journal of Science and Research (IJSR) 7(6):1419-1425. DOI: http://dx.doi.org/10.21275/ART20183477

Naqvi IH, Mahmood K, Salekeen S, Akhter ST. Determining the frequency and severity of malnutrition and correlating it with the severity of liver cirrhosis. Turk J Gastroenterol. 2013;24(5):415-422. DOI: http://dx.doi.org/10.4318/tjg.2013.0637.

Landa-Galván H. V., Milke-García M.ª P., León-Oviedo C., Gutiérrez-Reyes G., Higuera-de la Tijera F., Pérez-Hernández J. L. et al. Evaluación del estado nutricional de pacientes con cirrosis hepática alcohólica atendidos en la Clínica de Hígado del Hospital General de México. Nutr. Hosp. 2012; 27(6): 2006-2014. DOI: https://dx.doi.org/10.3305/nh.2012.27.6.6070.

Castellanos Fernández M., Santana Porbén S., García Jordá E., Rodríguez de Miranda A., Barreto Penié J., López Díaz Y. et al. Influencia de la desnutrición en la aparición de complicaciones y mortalidad en pacientes cirróticos. Nutr. Hosp. 2008; 23(1): 68-74. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112008000100011&lng=es.

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