A description of nutrition status, using Subjective Global Assessment on the patient population followed by the Urban Health Dietitian at St. Paul’s Hospital.
Bibliographic record
Abstract
Introduction: On average 45% of acute care patients in Canada are malnourished, increasing with length of stay (LOS). Patients followed by the Urban Health dietitian (UHD) at St. Paulu2019s Hospital (SPH) in Vancouver have a high incidence of Human Immunodeficiency Virus (HIV), infectious disease (including Hepatitis C (HCV)) and substance use disorders, which are well-known to decrease nutrition status (NS).Objectives: To describe (1) demographics of patients followed by the UHD at SPH and (2) patient NS upon admission and over their LOS, using Subjective Global Assessment (SGA) scores and parameters.Methods: A retrospective chart review of patients admitted between March 29 to October 12, 2018 was completed. Data compiled using descriptive analysis included demographics (age, sex, housing, HIV and HCV status), parameters from SGA (intake, weight changes, symptoms affecting intake, functional capacity, metabolic requirement, physical examination, and contributing factors (cachexia and sarcopenia)), initial SGA scores and subsequent weekly scores.Results:Of n=193, 80% were 35-64 years, 72% male, 63% HIV positive (HIV+), 17% homeless and 34% HCV positive. Upon initial assessment, 77% had inadequate intake, 85% high metabolic needs, 60% were malnourished (SGA B or C) and 70% had muscle loss (25% severe). Of patients who were severely malnourished (SGA C), 97% were HIV+. Considering LOS (n=100), over 90% of malnourished patients (n=52) improved NS in 1.8 weeks. Following dietitian intervention, 71% of patients were well-nourished, a 31% increase from admission. HCV and homelessness had minimal significance on NS.Conclusion: This study highlights the importance of using SGA to assess NS and of dietitian intervention in this population (specifically those HIV+), which had a 15% higher incidence of malnutrition than the Canadian average. Significance to the field of dietetics: This multi-morbidity population shows increased incidences of malnutrition. Continuation of early screening and dietitian intervention for HIV+ patients should be emphasized to improve NS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".