P4285 - The Impact of Malnutrition on Outcomes of Hospitalized Patients With Inflammatory Bowel Disease (IBD) in the United States

Kibwey Peterkin, MD¹, Carina-Leigh Lezama, MD², Shani Mc Lean, MD¹, Abiolah Telesford, MD¹, Jamal Perry, MD¹, Chidiebele Emmanuel Omaliko, MD¹, Ifeanyi Uche, MD¹, Chukwuka Eneh, MD¹, Farkhod Odilovich Parpibaev, MD¹, Oluwasegun Matthew Akinti, MD¹, Waleed Azzam Oweineh, MD¹, Jordan Carty, MD^3
1One Brooklyn Health-Brookdale University Hospital Medical Center, Brooklyn, NY; ²Peterborough City Hospital, Peterborough, England, United Kingdom; ³Einstein Healthcare Network, Philadelphia, PA

Introduction: Inflammatory bowel disease (IBD), encompassing Crohn's disease, ulcerative colitis, and microscopic colitis, is frequently linked to nutritional impairments, including protein-energy malnutrition (PEM). These nutritional deficits often contribute to adverse clinical outcomes. This study aims to investigate the impacts of malnutrition on the outcomes of patients hospitalized with IBD.

Methods: The National Inpatient Sample database from 2017 to 2020 was used to identify hospitalized patients with IBD, using relevant ICD-10 codes; inclusion criteria included adult patients. The patients were stratified into two groups based on the presence of malnutrition (protein-energy), using respective ICD-10 diagnostic codes. Malnutrition and its impact on outcomes in patients with IBD were evaluated. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay (LOS), total hospital charges (THC), intensive care unit (ICU) admission, sepsis, septic shock, acute kidney injury (AKI), toxic megacolon, and fulminant colitis. Multivariable regression analyses (accounting for patient and hospital characteristics) were performed

Results: The study population comprised 72,009 patients with IBD, of which 10,744 (14.92%) had concomitant malnutrition. On multivariate analysis, the presence of malnutrition was associated with increased odds of in-hospital mortality (adjusted odds ratio [aOR] 1.92, 95% confidence interval [CI] 1.25-2.94; P< 0.01). Patients with malnutrition had an increased LOS (3.53 days, 95% CI 3.36-3.69; P=0.00), higher THC ($28,832.83, 95% CI 26506.89-31158.77; P=0.00), increased odds receiving ICU care (aOR 2.24, 95% CI 1.74-2.88; P=0.00), increased odds of developing sepsis (aOR 1.25, 95% CI 1.09-1.45; P< 0.01) and septic shock (aOR 3.78, 95% CI 2.71-5.29; P=0.00), increased odds of developing AKI (aOR 1.11, 95% CI 1.03-1.21; P=0.00), and increased odds of developing toxic megacolon (aOR 7.89, 95% CI 4.03-15.47; P=0.00). The presence of malnutrition was not associated with the development of fulminant colitis.

Discussion: Malnutrition negatively impacts in-hospital mortality and leads to increased healthcare resource utilization, including longer hospital stays, higher hospital charges, an increased need for intensive care, and a higher odds of developing sepsis, septic shock, acute kidney injury, and toxic megacolon. These findings highlight the critical impact of malnutrition on clinical outcomes and healthcare utilization in IBD patients.


Disclosures:


Kibwey Peterkin, MD¹, Carina-Leigh Lezama, MD², Shani Mc Lean, MD¹, Abiolah Telesford, MD¹, Jamal Perry, MD¹, Chidiebele Emmanuel Omaliko, MD¹, Ifeanyi Uche, MD¹, Chukwuka Eneh, MD¹, Farkhod Odilovich Parpibaev, MD¹, Oluwasegun Matthew Akinti, MD¹, Waleed Azzam Oweineh, MD¹, Jordan Carty, MD³. P4285 - The Impact of Malnutrition on Outcomes of Hospitalized Patients With Inflammatory Bowel Disease (IBD) in the United States, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.