Article Abstract

Relationship between patient-generated subjective global assessment and survival in patients in palliative care

Authors: Celina Soares Carvalho, Daiane Spitz Souza, Jessica Rodrigues Lopes, Ivany Alves Castanho, Agnaldo José Lopes


Background: A significant number of cancer deaths is partly due to late diagnosis of the disease at an advanced stage beyond cure. In this context, by applying the adequate tools, palliative care provides terminal cancer patients with the proper support for survival with a higher quality of life. The objective of this study was to describe the nutritional profile of terminal cancer patients and to evaluate the relationship among Patient-Generated Subjective Global Assessment (PG-SGA) score, clinical-functional characteristics and survival.
Methods: The present work is a retrospective cohort study with 104 terminal cancer patients. The Karnofsky Performance Status (KPS) was used to obtain socio-demographic data and clinical history and assess functional capacity. Furthermore, patients were classified by groups and PG-SGA score ranges.
Results: In the first medical consultation, the PG-SGA revealed that most patients were moderately or severely malnourished and in critical need of immediate symptom management. Functional capacity of almost half of all patients lay within a KPS score of 40 to 70. Survival analysis revealed that the median time of mortality by cancer was 5 (3.3–6.7) months. Furthermore, patients with an SGA-C, i.e., severely malnourished (P<0.001), a PG-SGA score ≥9 (P=0.036) and a KPS score ≤40 (P<0.001) had a lower median time of survival.
Conclusions: In addition to evaluating nutritional status, the PG-SGA is directly related with survival in terminal cancer patients. The use of this tool in the studied population is of paramount importance to provide individualised and adequate support for these patients.