Frailty and Inflammatory Bowel Disease: A Scoping Review of Current Evidence

Abstract

Frailty is increasingly recognized as an important concept in patients with Inflammatory Bowel Disease (IBD). The aim of this scoping review is to summarize the current literature on frailty in IBD. We will discuss the definition of frailty, frailty assessment methods, the prevalence of frailty, risk factors for frailty and the prognostic value of frailty in IBD. A scoping literature search was performed using the PubMed database. Frailty prevalence varied from 6% to 53.9%, depending on the population and frailty assessment method. Frailty was associated with a range of adverse outcomes, including an increased risk for all-cause hospitalization and readmission, mortality in non-surgical setting, IBD-related hospitalization and readmission. Therefore, frailty assessment should become integrated as part of routine clinical care for older patients with IBD.

Preoperative Optimization of Crohn's Patients before Abdominopelvic Surgery

“…32 As such, it is important to identify patients at risk of frailty preoperatively and implement interventions such as physical therapy, ideally in the setting of a prehabilitation program, in order to prevent the progression of frailty. 33 Recently, the concept of formal prehabilitation programs to improve postoperative outcomes in frail patients has been highlighted, and the PREHAB randomized trial, and other studies, have shown promising results. 6,7,34 Anemia Anemia is another relatively common modifiable risk factor in patients with CD and may be related to nutritional deficiencies and blood loss from CD-related bleeding from ulcerations.…”

“…32 As such, it is important to identify patients at risk of frailty preoperatively and implement interventions such as physical therapy, ideally in the setting of a prehabilitation program, in order to prevent the progression of frailty. 33…”

Review article: Putting some muscle into sarcopenia—the pathogenesis, assessment and clinical impact of muscle loss in patients with inflammatory bowel disease

“…In evaluating these data, it is important to recognise that there is significant variability in the definition of frailty in the literature, ranging from decreased muscle mass/function to decreased endurance, involuntary weight loss, fatigue and reduced walking speed. This variability in the definition of frailty certainly limits the ability to utilise this data to better understand the impact of sarcopenia on IBD‐related outcomes 61 …”

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

“…Prevalence of frailty among patients with IBD ranges from 6% to 53.9% depending on the definition of frailty and the population studied [9][10][11].…”

“…Frailty carries several implications on the disease course of IBD patients, being independently associated with an increased risk of all-cause hospitalizations, readmissions, morbidity and mortality [8,10]. However, data on postoperative outcomes among frail IBD patients remain limited.…”