The Subjective Global Assessment (SGA) is a type of clinical tool doctors use to determine a person’s overall state of health.
It is most often used when assessing nutritional status in patients with kidney problems like end-stage renal disease or chronic renal insufficiency. The method is also useful when evaluating patients at risk for malnutrition.
Purpose of Test
If you are malnourished it is yespornplease very important that your doctor addresses the underlying cause. When your body is not getting adequate nutrition, your immune system can’t function as well. This puts you at risk for bacterial and viral infections. If you’re malnourished for a long time, you may be more likely to develop weak bones (osteoporosis) or complications from specific vitamin deficiencies (like blood clotting disorders).
If you are recovering from an illness, injury, or surgery, being malnourished will make it harder for your body to heal and increase your risk for complications.
When your body is deficient in energy and key vitamins, it will take longer for you to heal from even relatively mild illnesses like colds or injuries like cuts.
Conditions That Cause Malnourishment
The SGA can help doctors figure out why a person has become malnourished. Some conditions, such as HIV, AIDS, and cancer, cause the body to use a lot more energy. This can lead to severe weight loss and muscle wasting—a condition called cachexia. Muscle wasting occurs naturally as a person ages (sarcopenia) and doctors need to distinguish between normal changes to a person’s muscle mass and those caused by an infection, inflammation, or other potentially serious health problem.
This can lead to severe weight loss and muscle wasting—a condition called cachexia. Muscle wasting occurs naturally as a person ages (sarcopenia) and doctors need to distinguish between normal changes to a person’s muscle mass and those caused by an infection, inflammation, or other potentially serious health problem.
Malnutrition can also occur for other reasons—either because a person does not get enough to eat or their body is unable to absorb nutrition from what they eat. People who are very ill may have a lack of appetite or side effects from medications or treatments that make it difficult for them to eat.
For example, patients receiving chemotherapy may experience nausea and vomiting, people who are pregnant may experience a severe form of morning sickness called hyperemesis gravidarum, and people with depression may not feel like eating (due to the symptoms of their depression, the medications used to treat it, or both).
Certain medical disorders put a person at risk for malnourishment because they impact the body’s ability to absorb nutrition from the foods they eat. Malabsorption Syndrome can occur in a number of conditions, such as:
- gastrointestinal diseases such as Crohn’s or ulcerative colitis
- after weight-loss surgery
- cystic fibrosis
- celiac disease as well as various food allergies or intolerances
- some medications, including over-the-counter laxatives
- pancreatic insufficiency
- kidney disease
- liver disease
- conditions or infections that cause prolonged diarrhea
- certain genetic disorders or metabolic conditions
Malnourishment can also be brought about due to socioeconomic conditions. If a person is living in poverty, is elderly, or is disabled, they may not have regular access to nutritious food. In these cases, a medical professional will usually seek resources from their social services colleagues, government, or community-based programs.
Risks and Contraindications
Your doctor performs the SGA by looking at your medical record, asking you questions, and performing an exam. Depending on the reason for your visit, there may be other information you need to know (such as if you are having a test or procedure on the same day).
The medical staff may ask you about any medications or supplements you are taking. They may ask you to bring the bottle with you so they can check the dose and the name of the drug you have been prescribed with what they have in your medical record. You may be asked about any over-the-counter medications you take as well as if you eat or drink foods that may interact, such as alcohol or grapefruit.
Before the Test
You will not need to make an appointment for this evaluation. Doctors typically use SGA while taking your medical history and performing a physical exam.
SGA is used by a variety of medical professionals in different settings, including:
- routine doctor’s office visits (like your annual wellness exam)
- emergency room encounters
- pre-operation appointments or follow-up visits after a procedure
- during a hospital admission
What to Wear
You may be asked to change out of your street clothes and into a gown, especially if you will be undergoing certain medical tests, procedures, or surgery. Your doctor may allow you to stay in your regular clothes but may need you to give permission for them to examine you—such as by lifting your shirt so they can apply a stethoscope or feel your abdomen during an exam.
Food and Drink
You do not need to avoid eating or drinking for the SGA, but you may receive instructions specific to another test or procedure you will be having the same day. You will need to carefully follow these instructions, especially if you are having surgery.
The SGA is used to evaluate your nutritional status, so your doctor may ask you questions about your diet. They may also ask if you have any problems with eating or drinking, such as trouble swallowing or a loss of appetite.
They may also ask you questions about whether you have enough to eat or have trouble paying for groceries.
Cost and Health Insurance
SGA is performed as part of another exam. When it is done at your yearly checkup, for example, it may be covered completely by your insurance. When it is done as part of an evaluation in the emergency room, you may have a copay for the cost of the visit if you have insurance, or you may need to pay coinsurance.
If you don’t have health insurance, the cost of a doctor’s visit, emergency room visit, surgery, or hospital stay will vary widely depending on where you live and the length of the stay. If you have questions about your bill or aren’t able to pay, you can call the hospital’s billing department.