Is the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Comparable to the Subjective Global Assessment for Assessing Nutritional Status among Critically Ill Patients? ^†

Abstract

Malnutrition is an important factor in the survival of critically ill patients. Detailed nutrition assessment enables the early identification of malnourished patients and improves patient outcomes. To determine the prevalence of malnourished critically ill patients and assess the criterion validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (AND/ASPEN) among critically ill Palestinian patients against the reference standard for malnutrition, the Subjective Global Assessment (SGA), a cross-sectional study was conducted among 100 critically ill patients with a mean age of 43.9 ± 16.39 who were admitted to the ICU in main governmental hospitals in Palestine, from July 2020 to November 2020. The sensitivity, specificity, PPV, and NPV of the AND-ASPEN were analyzed against the SGA. ROC curve analysis was used to obtain the AUC and suitable optimal cutoff values for AND-ASPEN. According to the SGA and AND-ASPEN, 71% and 54% of the participants were malnourished, respectively. The sensitivity, specificity, PPV, and NPV for the AND-ASPEN were 0.718, 0.896, 0.944, and 0.565, respectively. The AUC of the AND-ASPEN was comparable to the SGA (0.859). The prevalence of malnutrition remains high among critically ill patients. The validity of the AND-ASPEN is comparable to the SGA, and the use of the AND-ASPEN to assess the nutritional status of this group is proposed, as it is simpler and more efficient. Underdiagnosis of malnutrition can be prevented, possibly reducing the prevalence of malnourished critically ill patients and improving the quality of the nutritional care process practiced in Palestine.