Evaluation of nutritional risk screening-2002 and subjective global assessment for general surgery patients: a prospective study.

Objective: To investigate the reliability of nutritional risk screening (NRS-2002) and Subjective Global Assessment (SGA) tools to predict the length of hospital stay, complications and mortality, and to compare these tools in predicting outcomes of surgical patients.

Methods: The prospective study was conducted at the Surgery Department of Numune Training and Research Hospital, Adana, Turkey, from March 30 to September 30, 2010. The patients were divided into 3 groups. Group 1 included patients requiring major surgical operations for gastrointestinal malignancy; Group 2 and 3 included patients undergoing moderate surgery and minor surgical operations respectively. Discrimination characteristics of the scoring systems were evaluated using receiver operating characteristic curves.

Results: Nutritional risk at admission was found to be increased in 132 (22.5%) patients by NRS-2002, and 90 (15.3%) by SGA. The sensitivity and specificity of NRS-2002 for complications were 53.3% and 96.6% respectively. The SGA values were 55% and 98.5% respectively. NRS-2002 and SGA at admission had a reliable power of discrimination (AUC > 0.8) for mortality and to predict complications in major gastrointestinal surgical patients.

Conclusion: SGA and NRS-2002 methods had positive predictive power in estimating the mortality risk in general surgical patient population. Both scoring tools were also positive in estimating post-operative complication risk in major surgical patients.