Adaptation of the “7-Points Subjective Global Assessment (SGA-7P) into Turkish and Evaluation of SGA-3P Compliance with Pilot Study on Hemodialysis Patients

Abstract

Aim: The seven-point subjective global assessment (SGA-7P), which was used to assess the nutritional status of dialysis patients, originally in English, was to demonstrate the Turkish equivalence (Semantic) of the form, to investigate the -agreement with the Subjective Global Assessment (SGA-3P).

Subjects and Methods: In order to ensure semantic equivalence, the English form was first translated into Turkish. The Turkish form was translated into English again. When it was decided that the two forms coincided, in a pilot study on 16 hemodialysis patients, SGA-7P was found to be compatible with SGA-3P. Then SGA-3P and SGA-7P were applied to 227 hemodialysis patients, some blood parameters and anthropometric measurements were evaluated.

Results: In the pilot study on 16 patients, Cohen Kappa test was found SGA-7P and SGA-3P with the agreement coefficient 0.862 and p<0.0001. The 227 patients who participated in the second stage, 30.4% were female, 69.6% were male. The mean age was 60.44±14.99 years. Negative and similar strength correlations were determined for SGA-3P and SGA-7P for serum albumin (r=-0.261, p <0.0001; r=-0.182, p=0.006), creatinine values before hemodialysis (r=-0.248, p<0.0001; r=-0.212 and p= 0.001), respectively Correlation analysis between anthropometric measures for SGA-3P and SGA-7P, for body weight (r=-0.347, p<0.0001; r=-0.243, p<0.0001), body mass index (BMI) (r=-0.300, p<0.0001; r=-0.199, p=0.003), mid upper arm circumference (MUAC) (r=-0.312, p<0.0001; r=-0.252, p<0.0001), triceps skinfold thickness (TST) (r=-0.369, p<0.0001; r=-0.190, p=0.007) and hand grip strength (r=-0.170, p=0.016; r=-0.157, p=0.026) were found to show a negative and similar strength correlations, respectively. The Kappa statistics between SGD-7P and SGD-3P were found 0.571. Serum albumin, total protein, creatinine, body weight, BMI, MUAC, TST, hand grip strengths for SGA-3P and SGA-7P showed statistically significant differences in well-nourished and mild-moderate-severe malnutrition patients.

Conclusion: SGA-7P was adapted to Turkish and found to be an appropriate tool to evaluate malnutrition status in hemodialysis patients.