Getting to the Meat of the Matter: Sarcopenia is Associated with Higher Mortality, Prolonged Stay, and Increased Costs in Patient’s Hospitalized With Crohn’s Disease
Document Type
Article
Abstract
Introduction:
Sarcopenia is defined as age-related decrease in skeletal muscle mass, which is often unrecognized if only body mass index (BMI) is used to determine nutritional status. Despite sarcopenia being very common in patients with inflammatory bowel disease (IBD), estimates of its prevalence and impact on clinical outcomes are variable. We attempted to compare hospital outcomes in patients with Crohn’s disease within this cohort.
Methods:
We conducted a retrospective study using the National Inpatient Sample (NIS) database. The database was inquired using the International Classification of Diseases Clinical Modification codes, 10th revision for patients admitted with Crohn's disease with and without sarcopenia from September 2015 (4th quarter) through January 2018 (1st quarter). Exclusion criteria included age < 18 years. SAS 9.4 software was used to run univariate and multivariate analysis to determine baseline characteristics, Elixhauser comorbidities, and to obtain outcomes. The primary outcome was in-hospital mortality, median length of stay, and median cost of hospitalization. Multivariate logistic regression analysis was performed to analyze age-adjusted mortality in specific groups.
Results:
Out of a total of 560,928 patients admitted between September 2015 through January 2018 with Crohn’s disease, 63,954 (11.4%) were identified with sarcopenia. The mean age was 52.9 ± 18.1 in the cohort group with sarcopenia. Most of the patients were Caucasians in both groups. Other patient-level characteristics are demonstrated in Table 1. The primary outcome of inpatient mortality was higher (1.8% vs. 0.7%, P < 0.0001), median length of stay was longer (4.8 vs. 3.5 days, P < 0.0001), and median cost of hospitalization was higher ($21,672 vs. $14,676, P < 0.0001) in the cohort with sarcopenia compared to the cohort without sarcopenia. The adjusted odds ratio for mortality was 1.57 (95% CI (1.22-1.89), P < 0.05).
Conclusion:
Sarcopenia is important for patients with Crohn’s disease as it is associated with poor outcomes, which is suspected to be due to bone demineralization, reduced mobility, pathological fractures, and compromised quality of life. Identifying risk factors for sarcopenia can help formulate interventions to target individualized reversible factors to improve outcomes in this cohort. Our study reaffirms the need for future large-scale prospective studies to understand the dynamic and progressive relationship between sarcopenia and Crohn's disease.
First Page
S767
DOI
10.14309/01.ajg.0000953684.61185.05
Publication Date
10-1-2023
Recommended Citation
Prenatt Z, Patel N, Bahirwani J, Bodrya K, Reddy-Patel N, Patel H, Patel DR, Chaput K, Schneider Y. S1011 Getting to the meat of the matter: sarcopenia is associated with higher mortality, prolonged stay, and increased costs in patient’s hospitalized with Crohn’s disease. Official journal of the American College of Gastroenterology| ACG. 2023 Oct 1;118(10S):S767.