Frailty Is Associated With All-Cause and Acute Hospitalisations During 18 Months Follow-Up in Older Patients With...

Guidelines recommend considering frailty in the management of older patients with Inflammatory Bowel Disease (IBD). A geriatric assessment is a specific and clinically applicable frailty assessment tool that could potentially predict both adverse outcomes and inform treatment decisions in older patients with IBD.

To examine the association of frailty with hospitalisations and mortality in older patients with IBD during 18 months follow-up.

This is a prospective, multicentre cohort study in older patients (age ≥ 65 years) with IBD. Frailty was measured using a geriatric assessment, covering five domains of functioning. Deficits in geriatric assessment reflect the level of frailty and were defined as: no deficits (0-1 impaired domains), moderate deficits (2-3 impaired domains) and severe deficits (4-5 impaired domains). Follow-up was aimed at after 18 months. Outcomes were all-cause, acute and IBD-related hospitalisation and mortality. Analyses were adjusted for age, sex and biochemical disease activity (C-reactive protein ≥ 10 mg/L and/or faecal calprotectin ≥ 250 μg/g).

Of 405 patients with median age 70 years, 160 (39.5%) had 2-3 geriatric deficits, 32 (7.9%) had 4-5 geriatric deficits. Severe deficits were independently associated with both all-cause (adjusted hazard ratio [aHR] 3.46, 95% confidence interval [CI] 1.67-7.16) and acute hospitalisations (aHR 3.45, 95% CI 1.59-7.51). Specifically, an impaired somatic domain was independently associated with all-cause hospitalisations (aHR 2.13, 95% CI 1.32-3.42) and acute hospitalisations (aHR 2.43, 95% CI 1.40-4.22).

Frailty, reflected by severe deficits in geriatric assessment, is independently associated with all-cause and acute hospitalisations in older patients with IBD.