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Subjective Global Nutritional Assessment: A Reliable Screening Tool for Nutritional Assessment in Cerebral Palsy
Priyanka Minocha1, Sadasivan Sitaraman2, Anita Choudhary1
1Department of Pediatrics, SMS Medical College and Hospital, Jaipur, Rajasthan, India.
Insights
Undernutrition is highly prevalent in children with cerebral palsy. The Subjective Global Nutritional Assessment (SGNA) is a reliable, cost-effective tool for screening nutritional status in this population.
Area of Science:
- Pediatric Nutrition
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) often presents challenges in nutritional assessment.
- Accurate nutritional status determination is crucial for managing CP.
- Prevalence of undernutrition in CP requires investigation.
Purpose of the Study:
- To determine the prevalence of undernutrition in children with cerebral palsy (CP).
- To compare subjective and objective methods for nutritional assessment in CP.
- To evaluate the Subjective Global Nutritional Assessment (SGNA) as a screening tool.
Main Methods:
- An analytical observational study included 180 children with CP (aged 1-12 years).
- Nutritional assessment utilized both subjective (SGNA) and objective (weight, height, triceps skinfold thickness) methods.
- Statistical analysis included agreement measures (Kappa statistic) and predictive values.
Main Results:
- Subjective assessment (SGNA) indicated a 76.67% prevalence of undernutrition.
- Objective measurements showed varying undernutrition rates: 48.89% (weight), 77.78% (height), and 35.18% (TSFT).
- SGNA demonstrated fair to moderate agreement with weight and height, but poor agreement with TSFT.
Conclusions:
- Undernutrition is highly prevalent in children with cerebral palsy.
- SGNA is a reliable, simple, non-invasive, and cost-effective tool for screening nutritional status in CP.
- SGNA can aid in early identification and management of undernutrition in this vulnerable group.
Objective:
To determine the prevalence of undernutrition in children with cerebral palsy and to compare subjective and objective methods of nutritional assessment.
Methods:
This was a hospital based analytical observational study in which 180 children of cerebral palsy, aged 1-12 y, attending tertiary level hospital, Jaipur from March, 2012 through March, 2013 were included. Subjective assessment was done by questionnaire (Subjective Global Nutritional Assessment; SGNA) in which questions related to nutrition history and physical examination, signs of fat, muscle wasting and edema was done while objective assessment was done by weight, height and triceps skinfold thickness (TSFT) measurements.
Results:
In this study prevalence of undernutrition by subjective method (SGNA) was 76.67% while by objective measurement (weight, height, TSFT) was 48.89%, 77.78% 35.18% respectively. There was fair to moderate agreement between the SGNA and objective assessments including weight and height (k = 0.341, p = 0.000; k = 0.337, p = 0.000 respectively) while for TSFT agreement between both methods was poor (k = 0.092, p = 0.190). In the index study, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SGNA was for weight was 95%, 37%, 56%, 90%; for height 84%, 50%, 85%, 47%; for TSFT 81%, 30%, 38%, 75% respectively.
Conclusions:
The prevalence of undernutrition is high in cerebral palsy children. SGNA can be a reliable tool for assessing nutritional status in children with cerebral palsy and is a simple, comprehensive, noninvasive, and cost-effective tool for screening undernutrition in children of cerebral palsy.
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