TRAINING FOR CLINICAL ASSESSMENT OF NUTRITIONAL STATUS IN SURGERY

Abstract

The percentage of malnutrition among surgical patients is reported as 30-60%. This situation may cause serious problems when overlooked. During the physical examination, exact knowledge for nutritional assessment is necessary for the clinician to notice the malnourished patient or those who is at increased risk. The initial clinical evaluation based on a Subjective Global Assessment (SGA) of the patient is a widely accepted approach. The aim of this study was to emphasize the importance of training on this method in a teaching hospital. Except the nutrition team specialist, clinicians were not informed about the protocol of the trial. 120 consecutively hospitalized surgical patients were included in this prospective study. A 3-hour training program about SGA was planned for the medical staff. The first 60 patients were evaluated before the training, and assigned as Group I. After the training program, the next 60 patients were evaluated by the same clinicians and assigned as group II. Nutrition team specialist reevaluated all patients for the verification of the assessments. There were only 2 (3.3%) patients considered as malnourished in Group I. Actually, 20% of them were found malnourished after the assessment of nutrition team specialist. The percentage of malnutrition was 33.3% in Group II (21.6% was moderate, and 11.3% was severely malnourished). The error rate for the identification of malnutrition after the training program was 3.3%, and the grade of malnutrition was 10%. The results of the study revealed the importance of accurate clinical assessment of nutritional status. It's obvious that, SGA data should take part in the routine examination forms of surgical patients.