Evaluation of Malnutrition Risk with Malnutrition Universal Screening Tool (MUST) in Inflammatory Bowel Disease Patients

Yıl 2021, Cilt: 1 Sayı: 1, 16 - 21, 29.10.2021

Sibel Çakıroğlu Seyit Uyar Ayhan Hilmi Çekin

Öz

Introduction: Malnutrition can lead to morbidity and mortalityin Inflammatory bowel diseases (IBD). Malnutrition screening tool (MUST) is a simple and easy-to-apply screening questionnaire developed for outpatiets. In this study, we aimed to evaluate the frequency of malnutrition risk with MUST in IBD patients.
Method: Between 01 April 2016 and 01 April 2017, patients diagnosed with IBD in outpatient and inpatient clinics of Gastroenterology were screened for malnutrition risk with MUST. Patients with a MUST score of ≥2 were concluded as high-risk for malnutrition. Results: A total of 216 IBD patients enrolled in this study. The study included a total of 177 (81.9%) patients from outpatient polyclinic and 39 (18.1%) from inpatient clinic. Risk of malnutrition was identified in 24.1% of patients according to MUST. Number of hospitalized patients with malnutrition rsik was significantly higher than the outpatient ones (71.7% vs. 13.5%, p<0,001). The frequency of high malnutrition risk was 21.7% in ulcerative colitis (UC) patients and 29.68% in Crohn's disease (CD) patients. The economic status of patients with malnutrition was significantly lower (0,010) and the history of surgery was significantly higher in patients with CD (p=0,002).
Conclusion: A quarters of IBD patients had a high risk of malnutrition in our study. The risk of hospitalized patients was much higher. Care should be taken with low economic status for all patients and in CD patients with a surgical history for malnutrition risk.

Anahtar Kelimeler

Inflammatory bowel disease, Malnutrition, Nutritional assessment

Kaynakça

• Reference1. Ko JK, Auyeung KK. Inflammatory bowel disease: etiology, pathogenesis and current therapy. Inflammatory bowel disease: etiology, pathogenesis and current therapy. Curr Pharm Des. 2014;20(7):1082-96. doi: 10.2174/13816128113199990416.
• Reference2. Lochs H, Allison SP, Meier R, Pirlich M, Kondrup J, Schneider S, et al. Introductory to the ESPEN guidelines on enteral nutrition: terminology, definitions and general topics. Clin Nutr Apr. 2006; 25(2): 180-6. doi: 10.1016/j.clnu.2006.02.007.
• Reference3. Gassul MA, Cabre E. Nutrition in inflammatory bowel disease. Curr Opin Clin Nutr Metab Care. 2001; 4: 561-9. doi: 10.1097/00075197-200111000-00018.
• Reference4. Gassull MA, Abad A, Cabre E, González-Huix F, Giné JJ, Dolz C. Enteral nutrition in inflammatory bowel disease. Gut. 1986;27:76-80. doi: 10.1136/gut.27.suppl_1.76.
• Reference5. Pirlich M, Schutz T, Kemps M, Luhman N, Burmester GR, Baumann G, et al. Prevalence of malnutrition in hospitalized medical patients: impact of underlying disease. Dig Dis. 2003;21(3): 245–251. doi: 10.1159/000073342.
• Reference6. Balestrieri P, Ribolsi M, Guarino MPL, Emerenziani S, Altomare A, Cicala M. Nutritional Aspects in Inflammatory Bowel Diseases. Nutrients. 2020;12(2):372. doi: 10.3390/nu12020372.
• Reference7. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415–21. doi:10.1016/s0261-5614(03)00098-0.
• Reference8. Stratton RJ, Hackston A, Longmore D, Dixon R, Price S, Stroud M, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br J Nutr. 2004;92:799-808. doi: 10.1079/BJN20041258.
• Reference9. Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36(1):49-64. doi: 10.1016/j.clnu.2016.09.004.
• Reference10. Cawood AL, Elia M, Sharp KS, Stratton RJ. Malnutrition self-screening by using MUST in hospital outpatients: validity, reliability, and ease of use. Am J Clin Nutr. 2012;96(5):1000-1007. doi: 10.3945/ajcn.112.037853.
• Reference11. Stratton RJ, King CL, Stroud MA, Jackson AA, Elia M. Malnutrition universal screening tool predicts mortality and length of hospital stay in acutely ill elderly. Br J Nutr. 2006;95(2):325-330. doi: 10.1079/bjn20051622.
• Reference12. Sandhu A, Mosli M, Yan B, Wu T, Gregor J, Chande N, et al. Self-Screening for Malnutrition Risk in Outpatient Inflammatory Bowel Disease Patients Using the Malnutrition Universal Screening Tool (MUST). J Parenter Enteral Nutr. 2016;40(4):507-10. doi: 10.1177/0148607114566656.
• Reference13. Keetarut K, Zacharopoulou-Otapasidou S, Bloom S, Majumdar A, Patel PS. An evaluation of the feasibility and validity of a patient-administered malnutrition universal screening tool ('MUST') compared to healthcare professional screening in an inflammatory bowel disease (IBD) outpatient clinic. J Hum Nutr Diet. 2017;30(6):737-745. doi: 10.1111/jhn.12481.
• Reference14. Csontos AA, Molnar A, Piri Z, Palfi E, Miheller P. Malnutrition risk questionnaire combined with body composition measurement in malnutrition screening in inflammatory bowel disease. Rev Esp Enferm Dig. 2017;109(1):26-32. doi: 10.17235/reed.2016.4557/2016.
• Reference15. Takaoka A, Sasaki M, Kurihara M, Iwakawa H, Inoue M, Bamba S, et al . Comparison of energy metabolism and nutritional status of hospitalized patients with Crohn's disease and those with ulcerative colitis. J Clin Biochem Nutr. 2015;56(3):208-14. doi: 10.3164/jcbn.14-95.
• Reference16. Valentini L, Schaper L, Bunning C, Hengstermann S, Koernicke T, Tillinger W, et al. Malnutrition and impaired muscle strength in patients with Crohn’s disease and ulcerative colitis in remission. Nutrition. 2008; 24: 694-702. doi: 10.1016/j.nut.2008.03.018.
• Reference17. Fávaro-Moreira NC, Krausch-Hofmann S, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, et al. Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data. Adv Nutr. 201616;7(3):507-22. doi: 10.3945/an.115.011254.