Nutritional Screening and Clinical Outcome in Hospitalized Patients with Crohn’s Disease

Abstract

Background/Aims: Hospitalized patients with Crohn’s disease (CD) can develop severe nutritional deficits. However, the nutritional screening tools with the most utility for such patients are still unknown. Methods: Nutritional status of 40 CD patients was assessed on admission using several screening tools and laboratory tests. Their validity was evaluated in relation to length of hospital stay (LOS) and intestinal resection. Receiver operating characteristic analysis was performed to predict prolonged LOS (≥28 days). Results: Prolonged LOS was correlated with each of the following screening parameters: Subjective Global Assessment, Nutrition Risk Screening 2002 (NRS 2002), Onodera’s Prognostic Nutritional Index (O-PNI), Controlling Nutritional Status, serum albumin level, and weight loss. These parameters were not correlated with intestinal resection. Evaluation of prognostic yield showed cutoff values of serum albumin 3.3 g/dL (AUC 0.797, sensitivity 57.1%, specificity 89.5%) and O-PNI 36.5 (0.749, 71.4%, 73.7%). By combining the serum albumin cutoff value and NRS 2002 score, patients were divided into 4 groups, with a prolonged LOS rate of 68.2% in the group with the worst prognosis. Conclusions: A combination of serum albumin (given the simplicity of testing) and NRS 2002 as nutritional screening tools may be useful for hospitalized CD patients.

Comparison of nutritional screening tools to assess nutritional risk and predict clinical outcomes in Mexican patients with digestive diseases

“…They compared SGA, NRI, anthropometry, biochemical tests, and bioelectrical impedance analysis in patients with digestive diseases and found that the SGA tool was more sensitive in detecting predictor factors, although the sensitivity of NRI was also very high [18]. A similar study by Allard et al [28] observed that of 318 patients with gastrointestinal disease, 45% were malnourished according to the SGA [34]. Our results are also similar to those of Tataoka et al, where 38% of 40 hospitalized patients with Crohn's disease were malnourished according to the SGA, but with the NRS-2002 the incidence was 68%, and evaluation using CONUT found that 25% of patients could be considered as severely malnourished [35].…”

Nutritional Aspects in Inflammatory Bowel Diseases

“…Malnutrition is one of the most important factors associated with a poor clinical outcome in patients with IBD [24,25]. The severity of malnutrition in IBD patients is dependent on the activity, duration, and extent of the disease and, in particular, on the magnitude of the inflammatory systemic…”

“…Malnutrition is one of the most important factors associated with a poor clinical outcome in patients with IBD [24,25]. The severity of malnutrition in IBD patients is dependent on the activity, duration, and extent of the disease and, in particular, on the magnitude of the inflammatory systemic response mediated by pro-inflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukins-1 and -6, which can increase catabolism and lead to anorexia [26].…”

Inflammatory cytokines, appetite‑regulating hormones, and energy metabolism in patients with gastrointestinal cancer

“…Indirect calorimetry was performed on fasted patients in the morning after resting in the supine position on a bed for 30 min. The measurements took ~10 min (35)(36)(37).…”