The Values of the Prognostic Nutrition Index and the Patient Generated -Subjective Global Assessment during the Nutritional Assessment of Patients with Gastrointestinal Tumors

Abstract: Objective To compare the value and consistency among the Patient Generated -Subjective Global Assessment (PG-SGA) and the Prognostic Nutrition Index (PNI) for assessing nutritional status in gastrointestinal tumor patients. Methods 251 patients from gastric cancer surgical ward from January 2019 to January 2020 were recruited through convenience sampling in this respective study. Nutritional screening and assessment were conducted for 251 gastrointestinal tumor patients using the nutritional risk screening 2002 (NRS 2002) PG-SGA, and the PNI. PNI was calculated using the serum albumin level and the total lymphocyte count obtained from the patients’ routine laboratory examination when they were admitted to the hospital. The receiver operating characteristic (ROC) of the PG-SGA and the PNI were plotted with the NRS 2002 used as the gold standard, and the diagnostic value of the PG-SGA and PNI was reflected by the area under the curve (AUC), sensitivity, specificity and Youden index. We then determined the optimal cut-off for the PNI and tested the consistency of the PG-SGA and PNI. Results The optimal cut-off point for the PNI was calculated to be 50.78. The AUC of the PG-SGA was 0.908 (95% CI 0.871-0.944). The sensitivity was 89.9%, specificity was 76.2% and the Youden index was 0.661. The AUC of the PNI was 0.594 (95% CI 0.516-0.572). The sensitivity was 73.8%, specificity was 44.3% and the Youden index was 0.181. In the consistency test, the kappa value was 0.838 (P < 0.001). Conclusion The PNI is of limited value for assessing malnutrition, although it did have good consistency with the PG-SGA. The combination of the PNI and PG-SGA can be used for diagnosing assessing malnutrition in clinical practice.