Simple Clinical Screening Underestimates Malnutrition in Surgical Patients with Inflammatory Bowel Disease—An ACS NSQIP Analysis

Mohamed A. Abd-El-aziz, Martin Hübner, Nicolas Demartines, David W. Larson, Fabian Grass

Research output: Contribution to journalArticlepeer-review

Abstract

The present large scale study aimed to assess the prevalence and consequences of malnutrition, based on clinical assessment (body mass index and preoperative weight loss) and severe hypoalbuminemia (<3.1 g/L), in a representative US cohort undergoing IBD surgery. The American College of Surgeons National Quality improvement program (ACS-NSQIP) Public User Files (PUF) between 2005 and 2018 were assessed. A total of 25,431 patients were identified. Of those, 6560 (25.8%) patients had severe hypoalbuminemia, 380 (1.5%) patients met ESPEN 2 criteria (≥10% weight loss over 6 months PLUS BMI < 20 kg/m2 in patients <70 years OR BMI < 22 kg/m2 in patients ≥70 years), and 671 (2.6%) patients met both criteria (severe hypoalbuminemia and ESPEN 2). Patients who presented with malnutrition according to any of the three definitions had higher rates of overall, minor, major, surgical, and medical complications, longer LOS, higher mortality and higher rates of readmission and reoperation. The simple clinical assessment of malnutrition based on BMI and weight loss only, considerably underestimates its true prevalence of up to 50% in surgical IBD patients and calls for dedicated nutritional assessment.

Original languageEnglish (US)
Article number932
JournalNutrients
Volume14
Issue number5
DOIs
StatePublished - Mar 1 2022

Keywords

  • Albumin
  • Crohn’s disease
  • Inflammatory bowel disease
  • Malnutrition
  • Surgery
  • Ulcerative colitis

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

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