SGA is a clinical diagnostic tool for use by trained clinicians. This output supports — it does not replace — clinician judgment. Document grade, date, assessor, and care plan in the patient record.
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SGA Nutritional
Clinical Nutrition
CLINICAL NUTRITION ASSESSMENT · ASPEN GRADE A · ESPEN 2024 · DETSKY 1987
SGA Nutritional
Assessment.
Subjective Global Assessment — the gold-standard bedside malnutrition diagnostic tool. 7 structured components synthesise into Grade A (well-nourished), B (mild–moderate), or C (severe malnutrition).
Detsky et al. 1987 · κ = 0.78
ASPEN Grade A Recommendation
ESPEN 2024 · GLIM Validated
7-Component Clinical Synthesis
SGA is a Clinical Synthesis Tool — Not Arithmetic Scoring.
Rate each component below, then use your clinical judgment to synthesise the overall grade. Physical findings (fat/muscle loss) carry significant weight. This tool guides your assessment — the clinician always makes the final classification. Results are for trained clinicians only (dietitians, medical officers, trained nurses).
WHAT SGA ASSESSES
Weight Change6-month loss + 2-week trend
Dietary IntakeSolid food vs liquid vs starvation
GI Symptoms>2 weeks: nausea · vomiting · anorexia
Functional CapacityNormal → reduced → bedridden
Physical ExamFat loss + muscle wasting 0–3+
Evidence-based Care PlanESPEN 2024 · ASPEN targets
TRAINED DIETITIAN
Clinical Nutrition
Consultation
Our clinical dietitians will complete a comprehensive SGA with full anthropometry, biochemistry, and a personalised MNT plan for your patient.
Book Consultation →GUIDELINE ENDORSEMENTS
ASPENGrade A — only recommended nutrition assessment tool for hospitalised adults
ESPEN 2024Grade A — cirrhosis, oncology, dementia, critical care
GLIM 2024Reference standard — κ = 0.8 vs GLIM criteria
ICMR/NIN IndiaCancer surgery, CKD — OR 5.27 for SGA-C adverse events
VALIDATED POPULATIONS
General medicine & surgeryOriginal Detsky 1987 validation (n=202)
Chronic kidney diseaseModified 7-point SGA used in dialysis
Cirrhosis / hepatic diseaseStratifies mortality risk; SGA-C predicts decompensation
Chronic heart failureMalnutrition rate 38.8% by SGA
Indian cancer surgeryValidated 2004; SGA superior to BMI-only screening
Frequently Asked Questions — SGA Nutritional Assessment
What is the SGA (Subjective Global Assessment)?
The Subjective Global Assessment (SGA) is a validated bedside clinical nutrition screening and diagnostic tool developed by Detsky et al. (JPEN 1987). It synthesises 7 components — weight change, dietary intake, GI symptoms, functional capacity, metabolic stress, subcutaneous fat loss, and muscle wasting — into a final grade: SGA-A (well-nourished), SGA-B (mild–moderate malnutrition), or SGA-C (severe malnutrition). Interobserver kappa = 0.78 (n=202).
Which guidelines endorse the SGA tool?
- ASPEN Grade A — the only recommended nutrition assessment tool for hospitalised adults
- ESPEN 2024 Grade A — endorsed for cirrhosis, oncology, dementia, and critical care
- GLIM 2024 — reference standard; κ = 0.8 vs GLIM criteria
- ICMR/NIN India — national recommendation for cancer surgery and CKD
- Canada CMTF — Best Practice: SGA within 24 hours of a positive nutrition risk screen
What does an SGA-C grade mean?
SGA-C indicates severe malnutrition. It requires same-day comprehensive dietitian assessment and urgent medical team notification. In Indian cancer surgery patients, SGA-C predicts an odds ratio of 5.27× higher postoperative adverse events (95% CI 1.35–20.51, p=0.016). Management includes 25–30 kcal/kg/day energy, 1.5–2.0 g protein/kg/day, mandatory refeeding syndrome monitoring, and daily reassessment.
How is the final SGA grade determined?
SGA is a clinical synthesis, not an arithmetic score. Physical exam findings (subcutaneous fat loss and muscle wasting, graded 0–3+) carry the greatest discriminatory weight. Severe physical wasting (3+) can override the weight-loss criterion and yield SGA-C even with moderate weight loss (Detsky 1987). The final grade is always determined by the trained clinician.
How often should SGA be repeated?
- SGA-A: every 7 days, or at any clinical change
- SGA-B: every 3–5 days
- SGA-C: daily until the patient is clinically stable
⚕️ Clinical Disclaimer: SGA is a diagnostic tool for trained clinicians (registered dietitians, medical officers, trained clinical nurses). This digital implementation guides structured assessment — the clinician always makes the final grade determination. SGA assesses protein-energy malnutrition only; supplement with micronutrient assessment, biochemical labs, and anthropometry for comprehensive MNT planning. Document SGA grade, date, assessor, contributing factors, and care plan initiated in the patient's medical record. Reassessment: SGA-A every 7 days; SGA-B every 3–5 days; SGA-C daily until stable. Interobserver kappa = 0.78 (Detsky 1987). For Indian patients, see ICMR/NIN guidelines; SGA-C is a stronger predictor than BMI in Indian populations with chronic energy deficiency.