Prognostic Value of the SGA and NUTRIC in the ICU
Prognostic Value of the SGA and NUTRIC in the ICU
There are two nutrition assessment tools that are commonly used in the ICU, namely the
 Subjective Global Assessment (SGA) and Modified Nutrition Risk in Critically Ill Score
 (mNUTRIC). It has been proposed that both assessments should be performed in the ICU but
 their combined prognostic ability has not been adequately assessed.

 This study aimed to: 1) determine the agreement between SGA and mNUTRIC scores, and 2)
 quantify their utility in discriminating and quantifying hospital mortality risk both
 independently and in combination.
This prospective observational study will be conducted in a 35-bed mixed ICU in Ng Teng Fong
 General Hospital, and all the intensivists and nurses will be blinded to the objectives of
 the study. All patients admitted to the ICU will be consecutively included in the study. For
 patients readmitted to the ICU during the same hospitalisation, only data from the first
 admission will be collected.

 As per routine care, all patients will have their nutritional status assessed by the
 dietitian within 48 hours of ICU admission. Information required for the nutritional
 assessment (SGA) will be obtained from the patients or their main care givers, and
 nutritional status will be dichotomized into well-nourished and malnourished.

 The electronic medical records automatically and prospectively collects all data required to
 calculate the mNUTRIC. At the end of the study, the mNUTRIC will be retrospectively
 calculated. Patients with values of "0-4" will be classified as low-mNUTRIC and "5-9" as
 high-mNUTRIC.

 The primary outcome will be hospital mortality and all patients will be followed until
 discharge or death, for up to one year after admission to the ICU.

 Agreement and mortality discriminative value (i.e. discrimination) of the 2-category
 classification of mNUTRIC (Low- and high-mNUTRIC) and SGA (SGA-A and SGA-B/C) will be
 assessed by Kappa statistics and C-statistics respectively.

 A multivariate logistic regression will be used to generate the adjusted odds ratios that
 quantify the association between high-mNUTRIC, malnutrition, and their combination (mNUTRIC ≥
 5 and SGA-B/C) with hospital mortality.
Inclusion Criteria:

 -  ≥ 18 years old who had ≥ 24 hours length of stay in the ICU

 -  received a nutrition assessment (SGA) from a dietitian within 48 hours of admission to
 the ICU

 Exclusion Criteria:

 -  Nil