Huang-Shen Lin1,2, Ming-Shyan Lin3, Ching-Chi Chi2,4, Jung-Jr Ye5, Ching-Chuan Hsieh2,6. 1. Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan. 2. College of Medicine, Chang Gung University, Taoyuan 33303, Taiwan. 3. Division of Cardiology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan. 4. Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan. 5. Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan. 6. Department of Nutrition, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.
Abstract
BACKGROUND: Malnutrition in patients with tuberculosis (TB) is associated with poor outcomes. This study assessed the validity of the patient-generated subjective global assessment (PG-SGA) in adult TB patients and examined the association of the PG-SGA score with adverse outcomes. METHODS: This is a retrospective chart review study compared with the well-nourished and malnourished TB patients. The nutritional status was determined using the PG-SGA for adult patients (n = 128). Clinical outcomes included liver injury and mortality. Adverse outcomes included hepatitis during anti-tuberculosis therapy. RESULTS: By comparing nutritional status using global assessment, well-nourished patients had a significantly higher body weight index (p = 0.002), a lower PG-SGA score (p < 0.001), and lower diabetic rate (p = 0.029). Malnourishment was a risk factor (p = 0.022) for liver injury and fatal outcomes (p < 0.001). A higher PG-SGA score was a risk factor for liver injury (p = 0.002) and an independent risk factor for fatal outcomes (p = 0.031). ROC analysis for outcome prediction showed that a PG-SGA score of 5.5 points yielded the most appropriate sensitivity (61.5%) and specificity (64.7%). CONCLUSION: Both global assessment and the total PG-SGA score were related to tuberculosis outcome and liver injury during anti-TB treatment.
BACKGROUND: Malnutrition in patients with tuberculosis (TB) is associated with poor outcomes. This study assessed the validity of the patient-generated subjective global assessment (PG-SGA) in adult TB patients and examined the association of the PG-SGA score with adverse outcomes. METHODS: This is a retrospective chart review study compared with the well-nourished and malnourished TB patients. The nutritional status was determined using the PG-SGA for adult patients (n = 128). Clinical outcomes included liver injury and mortality. Adverse outcomes included hepatitis during anti-tuberculosis therapy. RESULTS: By comparing nutritional status using global assessment, well-nourished patients had a significantly higher body weight index (p = 0.002), a lower PG-SGA score (p < 0.001), and lower diabetic rate (p = 0.029). Malnourishment was a risk factor (p = 0.022) for liver injury and fatal outcomes (p < 0.001). A higher PG-SGA score was a risk factor for liver injury (p = 0.002) and an independent risk factor for fatal outcomes (p = 0.031). ROC analysis for outcome prediction showed that a PG-SGA score of 5.5 points yielded the most appropriate sensitivity (61.5%) and specificity (64.7%). CONCLUSION: Both global assessment and the total PG-SGA score were related to tuberculosis outcome and liver injury during anti-TB treatment.