Malnutrition linked to increased risk for adverse events in IBD
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Use of a universal nutritional screening tool may help identify patients with inflammatory bowel disease who are at high risk for malnutrition and other adverse outcomes, according to data presented at the ACG Annual Scientific Meeting.
“Patients with IBD constitute a high-risk population for malnutrition. However, routine screening is not common practice, particularly in the outpatient setting,” Liat Gutin, MD, a gastroenterology fellow at Kaiser Permanente Northern California, said during a virtual poster presentation.
For their multicenter, retrospective cohort study, Gutin and colleagues applied the Malnutrition Universal Screening Tool (MUST) score to the electronic medical record of patients with IBD to assess malnutrition status and its relationship with IBD-related adverse outcomes.
The researchers included 12,530 patients with ulcerative colitis or Crohn’s disease at Kaiser Permanente Northern California who had at least two BMI measurements taken 3 to 6 months apart after IBD diagnosis date. The primary outcomes were incidence of venous thromboembolism, IBD-related hospitalization and IBD-related surgery within 1 year after assessment with the MUST score.
According to the MUST score, 86.5% of patients had low risk, 9.1% had medium risk and 4.4% had high risk for malnutrition. After adjusting for baseline demographic and clinical factors, patients in the high-risk group, as compared with the low-risk group, were more likely to experience venous thromboembolism (adjusted HR = 2.78; 95% CI, 1.32-2.78), IBD-related hospitalization (aHR = 1.9; 95% CI, 1.3-2.78) and IBD-related surgery (aHR = 2.37; 95% CI, 1.52-3.71) during 1-year follow-up. Similarly, the medium-risk group, as compared with the low-risk group, had a higher risk for venous thromboembolism (aHR = 1.84; 95% CI, 0.97-3.49), IBD-related hospitalization (aHR = 1.8; 95% CI, 1.34-2.42) and IBD-related surgery (aHR = 2.28; 95% CI, 1.6-3.26).
“For the first time, to our knowledge, using a nutritional screening tool applied to the EMR, we found that malnutrition status was significantly associated with risk of venous thrombotic events, IBD-related surgery and IBD-related hospitalization among outpatients with IBD,” Gutin said. “Routine application of the MUST score to the EMR can efficiently identify patients at risk for malnutrition and adverse outcomes within a population and concentrate nutritional and non-nutritional resources to those at greater risk.”
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Gutin L, et al. Increased risk of hospitalization, surgery and venous thromboembolism among patients with inflammatory bowel disease and malnutrition in a large, community-based healthcare system. Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).
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