Comparing Performance of NAF and NT-2013 to SGA as Nutritional Assessment Tools in Systemic Sclerosis Patients

Malnutrition is one of common complications of patients with systemic sclerosis (SSc). However, several nutritional assessment tools are implemented in Thailand. The study aimed to compare the performance of nutritional assessment tools including Nutritional Assessment Form (NAF) and Nutritional Triage 2013 (NT-2013) to Subjective Global Assessment (SGA) in SSc patients. A cross-sectional diagnostic study was conducted in adult SSc patients at Srinagarind Hospital, Thailand. To elucidate the efficacy and correlations of these tools, descriptive statistics, Pearson correlation analyses, and Kappa coefficient of agreement were employed. A total of 208 SSc patients were included, of which 71.6% were females. The respective mean age and body mass index was 59.3 years and 21.1 kg/m². Nearly half (45.7%) were malnourished based on SGA. Malnutrition diagnosis using the NAF and NT-2013 criteria were found in 80.3% and 34.6%, respectively. The respective sensitivity and specificity of NAF for diagnosis of malnutrition was 93.7% and 31.9%, while NT-2013 was 60.0% and 90.3%. Both NAF and NT-2013 had slight agreement with SGA with a kappa of 0.149 for NAF and 0.131 for NT-2013. Adjusting the cut-off points of NAF and NT-2013 could enhance sensitivity, specificity, and improve agreement for diagnosis with SGA.