Impact of Morbidity, Socio-demographic Variables and Length of Stay on the Nutritional Status of Patients through SGA Scores among Hospitalized Patients in Makkah Al-Mukarramah

Amin Abdulrahman Hafiz^1,

¹Department of Clinical Nutrition, Faculty of Applied Medical Sciences Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia

Cite this paper:
Amin Abdulrahman Hafiz. Impact of Morbidity, Socio-demographic Variables and Length of Stay on the Nutritional Status of Patients through SGA Scores among Hospitalized Patients in Makkah Al-Mukarramah. Journal of Food and Nutrition Research. 2025; 13(9):371-378. doi: 10.12691/jfnr-13-9-5

Abstract

The Self-Global Assessment (SGA) is a clinical nutrition assessment method widely used to assess the nutritional status of adults for clinical and research purposes. This tool facilitates the identification of clinically significant malnutrition and enables the monitoring of nutritional changes. Its practicality and comprehensive approach make it valuable for nutritional screening of a diverse patient population. This study aimed to validate the SGA criteria in identifying malnutrition and examine its association with illness, social factors, and length of hospital stay. The research focused on exploring how nutritional status relates to these variables and their impact on patient outcomes. This study was conducted from October 2023 to March 2024 in Makkah and included a random sample of 75 hospitalized patients. The cohort consisted of 40 men (53.3%) and 35 women (46.6%), with a mean age of 57.9 ± 12.9 years, and an age range of 18–75 years. Data collection included structured interviews using standardized SGA questionnaires, complemented by comprehensive physical and clinical examinations to determine the patients' nutritional status. Results revealed that morbidity was significantly affected by subcutaneous fat loss, muscle wasting, weight loss, and poor food intake (P < 0.05). Nutritional status, as assessed by SGA, showed significant associations with these clinical factors and related socioeconomic variables. Among the participants, 55 patients (73.3%) were classified as well-nourished, while 18 (24%) and 2 (2.7%) were classified as moderately and severely malnourished, respectively. Of note, the length of hospital stay was significantly longer in malnourished patients than in their well-nourished counterparts (P < 0.05). Malnutrition was found to be prevalent among hospitalized patients, with clear associations with sociodemographic variables, increased morbidity, and length of hospital stay. Early detection and timely nutritional interventions are critical to mitigate these negative effects. The Scale of Malnutrition (SGA) has proven to be a reliable, sensitive, and specific tool for early detection and assessment of malnutrition in various patient populations, confirming its suitability for routine use in clinical settings.

Keywords:
Key word: SGASubcutaneous fat Screening protocol severely malnourished well-nourished

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References:

[1]	World Health Organization (WHO). Palliative Care. Aug 2020.
[2]	Isenring E, Elia M. Which screening method is appropriate for older cancer patients at risk for malnutrition? Nutrition. 31(4): 594-597. April 2015.
[3]	Mendes NP, Barros TA, Rosa COB, Franceschini SDCC.Nutritional screening tools used and validated for cancer patients: a systematic review. Nutr Cancer. 71(6): 898-907. April 2019.
[4]	Isenring EA, Banks M, Ferguson M, Bauer JD. Beyond malnutrition screening: appropriate methods to guide nutritioncare for aged care residents. J AcadNutr Diet. 112(3): 376-381. March 2012.
[5]	Jones, J.M. The Methodology of Nutritional Screening and Assessment Tools. Journal of Human Nutrition and Dietetics.15 (1): 59-71. February 2002.
[6]	Kondrup, J., Allison, S.P., Elia, M., Vellas, B., Plauth, M. ESPEN Guidelines for Nutrition Screening. Clinical Nutrition. 22(4), 415-421. Augusts 2003.
[7]	ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the Use of Parenteral, Enteral Nutrition in Adult and Pediatric Patients.Journal of Parenteral and Enteral Nutrition, Volume26,Issue1SJanuary 2002.
[8]	Silva Fink, J., Daniel de Mello, P. and Daniel de Mello, E. Subjective Global Assessment of Nutritional Status-A Systematic Review of the Literature. Clinical Nutrition. 34(5): 785-92. October 2015.
[9]	Wu, B., Yin, T.T., Cao, W., Gu, Z.D., Wang, X., Yan, M. and Liu, B. Validation of the Chinese Version of the Subjective Global Assessment Scale of Nutritional Status in a Sample of Subjects with Gastrointestinal Cancer. International Journal of Nursing Studies,47(3), 323-331.march., 2010.
[10]	Locher, J.L., Bonner, J.A., Carroll, W.R., et al. Prophylactic Percutaneous Endoscopic Gastrostomy Tube Placement in Treatment of Head and Neck Cancer: A Comprehensive Review and Call for Evidence-Based Medicine. Journal of Parenteral and Enteral Nutrition, 35, 365-374. May 2011.
[11]	Isenring, E.A., Capra, S. and Bauer, J.D. Nutrition Intervention Is Beneficial in Oncology out Subjects Receiving Radiotherapy to the Gastrointestinal or Head and Neck Area. British Journal of Cancer, 91(3), 447-452augsts 2004.
[12]	Canzan, F., Caliaro, A., Cavada, M.L., Mezzalira, E., Paiella, S. and Ambrosi, E. The Effect of Early Oral Postoperative Feeding on the Recovery of Intestinal Motility after Gastrointestinal Surgery: Protocol for a Systematic Review and MetaAnalysis. PLOS ONE, 17, e0273085 Augusts 2022.
[13]	Planas M, Audivert S, PérezPortabella C, Burgos R, Puiggrós C, Casanelles JM, RossellóJ.Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of the genoma. Clin. Nutr. 23(5): 1016 -1024 October 2004.
[14]	Baccaro F, Moreno JB, BorlenghiC,Aquino L, Armesto G, Plaza G, Zapata S. Subjective GlobalAssessment in Clinical Setting. JPEN; 31 (5): 406 – 409. October2007.
[15]	Kyle UG, Schneider SM, PirlichM,Lochs H, Hebuterne X, Pichard C. Does nutritional risk, as assessed by Nutritional Risk Index, increase during hospital stay? A multinational population-based study. ClinNutr 24 (4): 516 – 524. Augusts 2005.
[16]	Lumbers M, New SA, Gibson S,Murphy MC. Nutritional status in elderly female hip fracture patients:comparison with an age matchedhome living group attending day centers. Br. J. Nutr. 85 (6): 733– 40.January 2001.
[17]	Ghimire S, Baral BK, Callahan K. Nutritional assessment of communitydwelling older adults in rural Nepal. PLoS One 12:e0172052. February 2017.
[18]	Verlaan S, Ligthart-Melis GC, Wijers SL, Cederholm T, Maier AB, devan der Schueren MA. High prevalence of physical frailty among community-dwelling malnourished older adults-a systematic review and meta-analysis. J Am Med Dir Assoc 18:374-382. may 2017.
[19]	Amarya S, Singh K, Sabharwal M. Changes during aging and their association with malnutrition. J ClinGerontolGeriatr; 6 (3): 78-84. September 2015.
[20]	Camina-Martín MA, de Mateo-Silleras B, Malafarina V, Lopez-MongilR, Niño-Martín V, López-Trigo JA, Redondo-del-Río MP. Nutritional status assessment in geriatrics: consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group. Maturitas 81(3): 414-419. May 2015.
[21]	Papparotto C, Bidoli E, Palese A. Risk factors associated with malnutrition in older adults living in Italian nursing homes: across-sectional study. Res GerontolNurs; 6 (3):187-197. july 2013.
[22]	Pineda JCC, Gómez García A, Velasco N, Graf JIDP, Adámes AM, Torre AM. Nutritional assessment of hospitalized patients in Latin America: association with prognostic variables. The ENHOLA study. NutrHosp; 33(3): 655-662. January 2016.
[23]	Fernández AC, Casariego AV, Rodríguez IC Pomar MDB. Eficaciayefectividad de lasdistintasherramientas de cribadonutricional en un hospital de tercernivel. NutrHosp 31:2240-6. May.2015.
[24]	Konturek PC, Herrmann HJ, Schink K, Neurath MF, Zopf Y. Malnutrition in Hospitals: It Was, Is Now, and Must Not Remain a Problem! Med SciMonit2; 21:2969–2975. October 2015.
[25]	Olivares J, Ayala L, Salas-Salvadó J, et al. Assessment of risk factors and test performance on malnutrition prevalence at admission using four different screening tools. NutrHosp 29(3): 674-680. Mar 2014.
[26]	Raslan M, Gonzalez MC, Torrinhas RS, Ravacci GR, Pereira JC, Waitzberg DL. Complementarity of Subjective Global Assessment (SGA) and Nutritional Risk Screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients. ClinNutr30(1): 49-53. February 2011.
[27]	Borek P, Chmielewski M, Małgorzewicz S, Slizie´n DA. Analysis of outcomesof the NRS 2002 in patients hospitalized in nephrology wards. Nutrients 16; 9(3): 287. March 2017.
[28]	Alghofaili, A. A., Aladel, A. I., Alsoghier, A. M., Othman, F.,Shoqeair, M. M., Alqahtani, S. M., Alnughaimish, A. M.,Alanazi, B. A., AI Mosallam, S. A., Alharbi, A. S., &Alquraishi, M. Association of Oral and GeneralHealth with Nutritional Status of Older Adults AttendingTwo Medical Centers in Riyadh, Saudi Arabia: A CrossSectional Study. Nutrients 15(18): 4032. September 2023.
[29]	Besora-Moreno, M., Llauradó, E., Tarro, L., &Solà, R. Social and Economic Factors and Malnutrition or the Riskof Malnutrition in the Elderly: A Systematic Review andMeta-Analysis of Observational Studies. Nutrients.11; 12(3): 737. March 2020.
[30]	Alzahrani, S. H., &Alamri, S. H. Prevalence of malnutrition and associated factors among hospitalized elderly patients in King Abdulaziz University Hospital, Jeddah,Saudi Arabia. BMC Geriatrics, 17(1): 136-142. July 2017.
[31]	italized older adults: a multicentre observational study of prevalence, associations andoutcomes. J Nutr Health Aging 21(7): 830-836. July 2017.
[32]	Barker LA, Gout BS, Crowe TCJIjoer, health p. Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system. 8(2): 514-527 February 2011.
[33]	Khalatbari-Soltani S, Marques-Vidal PJCnE. The economic cost of hospital malnutrition in Europe; a narrative review. 10(3):e89-e94. January 2015.
[34]	Norman K, Pichard C, Lochs H, PirlichMJCn. Prognostic impact of disease-related malnutrition.ClinNutr.27(1): 5-15 February 2008.
[35]	Velasco C, García E, Rodríguez V, Frías L, Garriga R, Álvarez J, et al. Comparison of fournutritional screening tools to detect nutritional risk in hospitalized patients: a multicentre study.ClinNutr. 65(2): 269-274. February 2011.