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Published on: September 20, 2018
Development of a screening tool to detect nutrition risk in patients with inflammatory bowel disease
Natasha Haskey1, Juan Nicolás Peña-Sánchez2,3, Jennifer L Jones4
1Multidisciplinary Inflammatory Bowel Disease Clinic, Division of Gastroenterology, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. natasha.haskey@gmail.com; nhaskey@shaw.ca.
Background And Objectives:
Malnutrition is a known complication of Inflammatory Bowel Disease (IBD). We assessed a known screening tool, as well as developed and validated a novel screening tool, to detect nutrition risk in outpatients with IBD.
Methods And Study Design:
The Saskatchewan IBD-Nutrition Risk (SaskIBD-NR Tool) was developed and administered alongside the Malnutrition Universal Screening Tool (MUST). Nutrition risk was confirmed by the IBD dietitian (RD) and gastroenterologist (GI). Agreement between screening tools and RD/GI assessment was computed using Cohen's kappa.
Results:
Of the 110 patients screened, 75 (68.2%) patients had Crohn's Disease and 35 (31.8%) ulcerative colitis. Mean BMI was 26.4 kg/m2 (SD=5.8). RD/GI assessment identified 23 patients (20.9%) at nutrition risk. The SaskIBD-NR tool classified 21 (19.1%) at some nutrition risk, while MUST classified 17 (15.5%). The SaskIBD-NR tool had significant agreement with the RD/GI assessment (k 0.83, p<0.001), while MUST showed a lack of agreement (k 0.15, p=0.12). The SaskIBD-NR had better sensitivity (82.6% vs 26.1%), specificity (97.7% vs 87.4%), positive predictive value (90.5% vs 35.3%), and negative predictive value (95.5% vs 81.7%) than the MUST.
Conclusion:
The SaskIBD-NR, which assesses GI symptoms, food restriction, and weight loss, adequately detects nutrition risk in IBD patients. Broader validation is required.
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