SUBJECTIVE GLOBAL ASSESSMENT - ALTERNATIVE NUTRITION-ASSESSMENT TECHNIQUE FOR LIVER-TRANSPLANT CANDIDATES

The interpretation of most objective nutrition assessment parameters i s affected by liver disease. A subjective global assessment (SGA) tool adapted for assessment of adult liver-transplant candidates was evalu ated for interobserver reproducibility. Two dietitians assessed 20 liv er-transplant candidates in regard to 25 SGA parameters based on patie nt history, physical appearance, and existing clinical conditions. Fif teen percent of the patients were found to be well nourished, 70% mode rately malnourished, and 15% severely malnourished. Raters agreed on t he nutrition status of the patients 80% of the time. Twelve individual parameters showed fair to good interrater reliability (kappa greater- than-or-equal-to 0.500). Muscle wasting and fat depletion were determi ned to be the strongest predictors of the final SGA rating (kappa = 0. 737,p < 0.0001, kappa = 0.632, p < 0.0001, respectively). The assessme nt tool itself was determined to be reliable by the Cronbach coefficie nt alpha-test (0.707). Although this assessment method has limitations , the findings of this study suggest that SGA as an alternative test f or assessing the nutrition status of adult liver-transplant candidates has an overall fair to good interobserver reproducibility rate.