Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Communication
  • Published:

The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy

Abstract

Objective: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL).

Design: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area.

Setting: Australian radiation oncology facilities.

Subjects: Sixty cancer patients aged 24–85 y.

Interventions: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3).

Results: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r=−0.66, P<0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P<0.001) and SGA (P<0.001); and a decrease in global QoL (P<0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P<0.001) and change in global QoL (P=0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r=−0.55, P<0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P=0.001).

Conclusion: The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.

Sponsors: The Wesley Research Institute.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • Aaronson, NK, Ahmedzai, S, Bergman, B, Bullinger, M, Cull, A, Duez, NJ, Filiberti, A, Flechtner, H, Fleishman, SB & de Haes, JC (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J. Natl. Cancer Inst., 85, 365–376.

    Article  CAS  PubMed  Google Scholar 

  • Andreyev, HJ, Norman, AR, Oates, J & Cunningham, D (1998). Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies?. Eur. J. Cancer, 34, 503–509.

    Article  CAS  PubMed  Google Scholar 

  • Baldwin, C, Parsons, T & Logan, S (2001). Dietary advice for illness-related malnutrition in adults. Cochrane Database Syst. Rev., 2, CD002008

  • Bauer, J, Capra, S & Ferguson, M (2002). Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur. J. Clin. Nutr., 56, 1–7.

    Article  Google Scholar 

  • Bjordal, K & Kaasa, S (1992). Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol., 31, 311–321.

    Article  CAS  PubMed  Google Scholar 

  • Coates, A, Porzsolt, F & Osoba, D (1997). Quality of life in oncology practice: prognostic value of EORTC QLQ-C30 scores in patients with advanced malignancy. Eur. J. Cancer, 33, 1025–1030.

    Article  CAS  PubMed  Google Scholar 

  • Detsky, AS, McLaughlin, JR, Baker, JP, Johnston, N, Whittaker, S, Mendelson, RA & Jeejeebhoy, KN (1987). What is subjective global assessment of nutritional status?. J. Parenter. Enteral Nutr., 11, 8–13.

    Article  CAS  Google Scholar 

  • Evans, WK, Nixon, DW, Daly, JM, Ellenberg, SS, Gardner, L, Wolfe, E, Shepherd, FA, Feld, R, Gralla, R & Fine, S et al (1987). A randomized study of oral nutritional support versus ad lib nutritional intake during chemotherapy for advanced colorectal and non-small-cell lung cancer. J. Clin. Oncol., 5, 113–124.

    Article  CAS  PubMed  Google Scholar 

  • Fayers, P, Aaronson, N, Bjordal, K & Sullivan, M (1999). EORTC QLQ-C30, Scoring Manual, Belgium: EORTC Data Center

    Google Scholar 

  • Grant, M & Rivera, L (1994). Impact of dietary counselling on quality of life in head and neck patients undergoing radiation therapy. Qual. Life Res., 3, 77–78.

    Article  Google Scholar 

  • Hammerlid, E, Wirblad, B, Sandin, C, Mercke, C, Edstrom, S, Kaasa, S, Sullivan, M & Westin, T (1998). Malnutrition and food intake in relation to quality of life in head and neck cancer patients. Head Neck., 20, 540–548.

    Article  CAS  PubMed  Google Scholar 

  • Hjermstad, MJ, Fossa, SD, Bjordal, K & Kaasa, S (1995). Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. J. Clin. Oncol., 13, 1249–1254.

    Article  CAS  PubMed  Google Scholar 

  • King, MT (1996). The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Qual. Life Res., 5, 555–567.

    Article  CAS  PubMed  Google Scholar 

  • Larsson, J, Akerlind, I, Permerth, J & Hornqvist, JO (1995). Impact of nutritional state on quality of life in surgical patients. Nutrition, 11, (2 Suppl) 217–220.

    CAS  PubMed  Google Scholar 

  • Niezgoda, HE & Pater, JL (1993). A validation study of the domains of the core EORTC quality of life questionnaire. Qual. Life Res., 2, 319–325.

    Article  CAS  PubMed  Google Scholar 

  • Nitenberg, G & Raynard, B (2000). Nutritional support of the cancer patient: issues and dilemmas. Crit. Rev. Oncol. Hematol., 34, 137–168.

    Article  CAS  PubMed  Google Scholar 

  • Ohrn, KE, Sjoden, PO, Wahlin, YB & Elf, M (2001). Oral health and quality of life among patients with head and neck cancer or haematological malignancies. Support. Care Cancer, 9, 528–538.

    Article  CAS  Google Scholar 

  • Ollenschlager, G, Viell, B, Thomas, W, Konkol, K & Burger, B (1991). Tumor anorexia: causes, assessment, treatment. Rec. Results Cancer Res., 121, 249–259.

    Article  CAS  Google Scholar 

  • Osoba, D, Rodrigues, G, Myles, J, Zee, B & Pater, J (1998). Interpreting the significance of changes in health-related quality-of-life scores. J. Clin. Oncol., 16, 139–144.

    Article  CAS  PubMed  Google Scholar 

  • Ottery, FD (1996b). Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition, 12, (Suppl 1) S15–S19.

    Article  CAS  PubMed  Google Scholar 

  • Ottery, F (2000). Patient-Generated Subjective Global Assessment. In:The Clinical Guide to Oncology Nutrition, ed. P McCallum & C Polisena Chicago, IL: American Dietetic Association pp11–23.

    Google Scholar 

  • Ottery, F, Bender, F & Kasenic, S (2002). The design and implementation of a model of nutritional oncology program. Oncol. Iss., 17, (2 Suppl) 3–8.

    Google Scholar 

  • Ovesen, L, Hannibal, J & Mortensen, EL (1993). The interrelationship of weight loss, dietary intake, and quality of life in ambulatory patients with cancer of the lung, breast, and ovary. Nutr. Cancer, 19, 159–167.

    Article  CAS  PubMed  Google Scholar 

  • Persson, C, Sjoden, PO & Glimelius, B (1999). The Swedish version of the patient-generated subjective global assessment of nutritional status: gastrointestinal vs urological cancers. Clin. Nutr., 18, 71–77.

    Article  CAS  PubMed  Google Scholar 

  • Rivadeneira, DE, Evoy, D, Fahey, TJ III, Lieberman, MD & Daly, JM (1998). Nutritional support of the cancer patient. Cancer J. Clin., 48, 69–80.

    Article  CAS  Google Scholar 

  • Sanders, C, Egger, M, Donovan, J, Tallon, D & Frankel, S (1998). Reporting on quality of life in randomised controlled trials: bibliographic study. Br. Med. J., 317, 1191–1194.

    Article  CAS  Google Scholar 

  • Shike, M (1996). Nutrition therapy for the cancer patient. Hematol. Oncol. N. Am., 10, 221–234.

    Article  CAS  Google Scholar 

  • Small, W, Carrara, R, Danford, L, Logemann, J & Cella, D (2002). Quality of life and nutrition in the patient with cancer. Oncol. Iss., 17, (2 Suppl) 15–16.

    Google Scholar 

  • Tchekmedyian, NS, Zahyna, D, Halpert, C & Heber, D (1992). Assessment and maintenance of nutrition in older cancer patients. Oncology (Huntington), 6, (2 Suppl) 105–111.

    CAS  Google Scholar 

  • van Bokhorst-de van der, S, van Leeuwen, PA, Kuik, DJ, Klop, WM, Sauerwein, HP, Snow, GB & Quak, JJ (1999). The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer, 86, 519–527.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Dr Diana Battistutta for statistical advice.

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Isenring, E., Bauer, J. & Capra, S. The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 57, 305–309 (2003). https://doi.org/10.1038/sj.ejcn.1601552

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1601552

Keywords

This article is cited by

Search

Quick links