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Nutritional Screening and Clinical Outcome in Hospitalized Patients with Crohn's Disease
Azusa Takaoka1, Masaya Sasaki1, Naoko Nakanishi1
1Division of Clinical Nutrition, Shiga University of Medical Science, Otsu, Japan.
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.
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