The subjective global assessment predicts in-hospital mortality better than other nutrition-related risk indexes in noncritically ill inpatients who receive total parenteral nutrition in Spain (prospective multicenter study)

J Acad Nutr Diet. 2013 Sep;113(9):1209-18. doi: 10.1016/j.jand.2013.05.027.


Malnutrition in hospitalized patients is associated with an increased risk of death and complications. The purpose of this study was to determine which nutrition-related risk index predicts mortality better in patients receiving total parenteral nutrition. This prospective, multicenter study involved noncritically ill patients who were prescribed total parenteral nutrition. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index, Geriatric Nutritional Risk Index, body mass index, albumin and prealbumin, as well as in-hospital mortality, length of stay, and infectious complications. Of the 605 patients included in the study, 18.8% developed infectious complications and 9.6% died in the hospital. SGA, albumin, Nutritional Risk Index and Geriatric Nutritional Risk Index were associated with longer hospital stay. Prealbumin levels were associated with infectious complications. Multiple logistic regression analysis showed (after adjustment for age, sex, C-reactive protein levels, mean blood glucose levels, use of corticoids, prior comorbidity, carbohydrates infused, diagnosis, and infectious complications) that the SGA, Geriatric Nutritional Risk Index, body mass index, albumin, and prealbumin were associated with an increased risk for in-hospital mortality. SGA was the tool that best predicted mortality and adequately discriminated the values of the other nutrition-related risk indexes studied. The SGA is a clinically effective and simple tool for nutrition assessment in noncritically ill patients receiving total parenteral nutrition and detects the risk of inpatient mortality better than others.

Keywords: Mortality; Nutritional assessment; Subjective Global Assessment; Total parenteral nutrition.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Energy Intake
  • Hospital Mortality*
  • Hospitalization
  • Humans
  • Infections / complications
  • Length of Stay
  • Malnutrition / diagnosis
  • Malnutrition / mortality*
  • Middle Aged
  • Nutrition Assessment*
  • Parenteral Nutrition, Total / mortality*
  • Prealbumin / analysis
  • Prospective Studies
  • Risk Assessment
  • Serum Albumin / analysis
  • Spain


  • Prealbumin
  • Serum Albumin
  • C-Reactive Protein