Development of a screening tool to detect nutrition risk in patients with inflammatory bowel disease

Asia Pac J Clin Nutr. 2018;27(4):756-762. doi: 10.6133/apjcn.112017.01.

Abstract

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.

MeSH terms

  • Female
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / etiology*
  • Mass Screening / methods
  • Nutrition Assessment*
  • Nutritional Status*
  • Reproducibility of Results
  • Risk Factors
  • Surveys and Questionnaires