Comparison of Nutritional Risk Index with Subjective Global Assessment in Evaluating the Nutritional Status of Liver Transplant Candidates

Document Type : Research Paper


1 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Mashhad Transplant Research Center, Montasryieh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.



Introduction: We launched this study to compare subjective global assessment (SGA) and nutrition risk index (NRI) as malnutrition screening tools for nurses to use in the care of End-stage Liver Disease (ESLD) patients. Methods: This pilot study was conducted on liver transplant patients in two hospitals in Iran from May to September 2021. Sensitivity, specificity, and predictive values of NRI were evaluated compared with SGA in ESLD patients. Results: Sixty-five cirrhotic patients were assessed. The sensitivity, specificity, positive and negative predictive values for NRI in detecting malnutrition based on SGA were 97.67%, 31.82%, 77.68%, and 87.5%, respectively. However, the agreement between NRI and SGA was low (k=0.349). Changing the NRI cut-off value to 83.7 could yield acceptable sensitivity (72.7%) and specificity (58.1%). Conclusion: NRI can be used as a screening tool in ESLD patients, but a different cut-off might be required to improve its validity against SGA in ESLD patients.


Main Subjects

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Volume 11, Issue 3
September 2023
Pages 185-192
  • Receive Date: 26 June 2023
  • Revise Date: 19 July 2023
  • Accept Date: 22 July 2023
  • First Publish Date: 22 July 2023