Handgrip strength and risk of malnutrition are associated with an increased risk of hospitalizations in inflammatory bowel disease patients

Katherine Bedard; Lorian Taylor; Naheed Rajabali; Karen Kroeker; Brendan Halloran; Guanmin Meng; Maitreyi Raman; Puneeta Tandon; Juan G Abraldes; Farhad Peerani

doi:10.1177/17562848231194395

Handgrip strength and risk of malnutrition are associated with an increased risk of hospitalizations in inflammatory bowel disease patients

Therap Adv Gastroenterol. 2023 Aug 31:16:17562848231194395. doi: 10.1177/17562848231194395. eCollection 2023.

Authors

Affiliations

¹ Department of Medicine, Faculty of Graduate Studies and Research, University of Alberta, Edmonton, AB, Canada.
² Department of Medicine, University of Calgary, Calgary, AB, Canada.
³ Division of Geriatric Medicine, University of Alberta, Edmonton, AB, Canada.
⁴ Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada.
⁵ Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
⁶ Division of Gastroenterology, University of Alberta, 1-59 Zeidler Ledcor Centre, 8540 - 112 Street NW, Edmonton AB T6G 2P8, Canada.

Abstract

Background: In patients with inflammatory bowel disease (IBD), frailty is independently associated with mortality and morbidity.

Objectives: This study aimed to extend this work to determine the association between the clinical frailty scale (CFS), handgrip strength (HGS), and malnutrition with IBD-related hospitalizations and surgeries.

Design: IBD patients ⩾18 years of age were prospectively enrolled from two ambulatory care clinics in Alberta, Canada.

Methods: Frailty was defined as a CFS score ⩾4, dynapenia as HGS < 16 kg for females and <27 kg for males, malnutrition using the subjective global assessment (SGA), and the risk of malnutrition using either the abridged patient-generated SGA (abPG-SGA), or the Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRT). Logarithm relative hazard graphs and multivariable logistic regression models adjusting for relevant confounders were constructed.

Results: One hundred sixty-one patients (35% ulcerative colitis, 65% Crohn's disease) with a mean age of 42.2 (±15.9) years were followed over a mean period of 43.9 (±10.1) months. Twenty-seven patients were hospitalized, and 13 patients underwent IBD-related surgeries following baseline. While the CFS (aHR 1.34; p = 0.61) and SGA (aHR 0.81; p = 0.69) did not independently predict IBD-related hospitalizations, decreased HGS (aHR 3.96; p = 0.03), increased abPG-SGA score (aHR 1.07; p = 0.03) and a SaskIBD-NRT ⩾ 5 (aHR 4.49; p = 0.02) did. No variable was independently associated with IBD-related surgeries.

Conclusion: HGS, the abPG-SGA, and the SaskIBD-NRT were independently associated with an increased risk of IBD-related hospitalizations. Future studies should aim to validate other frailty assessments in the IBD population in order to better tailor care for all IBD patients.

Keywords: dynapenia; frailty; hospitalizations; inflammatory bowel disease; malnutrition.