Systematic review of nutrition screening and assessment in inflammatory bowel disease

被引:59
作者
Li, Suqing [1 ]
Ney, Michael [2 ]
Eslamparast, Tannaz [3 ]
Vandermeer, Ben [4 ]
Ismond, Kathleen P. [3 ]
Kroeker, Karen [3 ]
Halloran, Brendan [3 ]
Raman, Maitreyi [2 ]
Tandon, Puneeta [3 ]
机构
[1] Univ Alberta, Div Internal Med, Dept Med, Fac Med & Dent, Edmonton, AB T6G 2G3, Canada
[2] Univ Calgary, Div Gastroenterol & Liepatol, Dept Med, 6D33 TRW Bldg,3280 Hosp Dr NW, Calgary, AB T2N 2T9, Canada
[3] Univ Alberta, Cirrhosis Care Clin, Div Gastroenterol, Dept Med,Fac Med & Dent, Edmonton, AB T6G 2X8, Canada
[4] Univ Alberta, Alberta Res Ctr Hlth Evidence, Fac Med & Dent, Edmonton, AB T6G 1C9, Canada
关键词
Nutrition; Inflammatory bowel disease; Ulcerative colitis; Crohn's disease; Screening; Outcomes research; SUBJECTIVE GLOBAL ASSESSMENT; CROHNS-DISEASE; ULCERATIVE-COLITIS; CLINICAL-OUTCOMES; MALNUTRITION; SARCOPENIA; TOOL; RISK; CONSENSUS; INFLIXIMAB;
D O I
10.3748/wjg.v25.i28.3823
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND Malnutrition is prevalent in inflammatory bowel disease (IBD). Multiple nutrition screening (NST) and assessment tools (NAT) have been developed for general populations, but the evidence in patients with IBD remains unclear. AIM To systematically review the prevalence of abnormalities on NSTs and NATs, whether NSTs are associated with NATs, and whether they predict clinical outcomes in patients with IBD. METHODS Comprehensive searches performed in Medlin, CINAHL Plus and PubMed. Included: English language studies correlating NSTs with NATs or NSTs/NATs with clinical outcomes in IBD. Excluded: Review articles/case studies; use of body mass index/laboratory values as sole NST/NAT; age < 16. RESULTS Of 16 studies and 1618 patients were included, 72% Crohn's disease and 28% ulcerative colitis. Four NSTs (the Malnutrition Universal Screening Tool, Malnutrition Inflammation Risk Tool (MIRI), Saskatchewan inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRI) and Nutrition Risk Screening 2002 (NRS-2002) were significantly associated with nutritional assessment measures of sarcopenia and the Subjective Global Assessment (SGA). Three NSTs (MIRT, NRS-2002 and Nutritional Risk Index) were associated with clinical outcomes including hospitalizations, need for surgery, disease flares, and length of stay (LOS). Sarcopenia was the most commonly evaluated NAT associated with outcomes including the need for surgery and post-operative complications. The SGA was not associated with clinical outcomes aside from LOS. CONCLUSION There is limited evidence correlating NSTs, NATs and clinical outcomes in IBD. Although studies support the association of NSTs/NATs with relevant outcomes, the heterogeneity calls for further studies before an optimal tool can be recommended. The NRS-2002, measures of sarcopenia and developments of novel NSTs/NATs, such as the MIRT, represent key, clinically-relevant areas for future exploration.
引用
收藏
页码:3823 / 3837
页数:15
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