eP253 - Frailty in Inflammatory Bowel Disease: Analysis of the National Inpatient Sample 2015–2019

Sunday, June 2, 2024

11:03 AM – 11:08 AM ET, USA

Location: Baltimore Convention Center, Room 318-320

ePoster Presenter(s)

SS

Sahil Sharma, MD

General Surgery Resident
McMaster University
McMaster University
Hamilton, ON, Canada

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Tyler McKechnie, MD, MSc (he/him/his)

Resident Physician
McMaster University
McMaster University
Hamilton, ON, Canada

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
LH

Luke Heimann, N/A

Student
Liberty University
ventura, California, United States

Disclosure information not submitted.
NA

Nalin Amin, MD, FRCS(C)

Associate Professor
McMaster University
Ancaster, Ontario, Canada

Disclosure information not submitted.
DH

Dennis Hong, MD, M.S.c, FRCSC, FACS

Associate Professor
McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.

Senior Author(s)

CE

Cagla Eskicioglu, MD, Msc, FRCSC

Associate Professor, Colon & Rectal Surgeon
Faculty of Health Sciences, McMaster University
Hamilton, Ontario, Canada

Disclosure information not submitted.

Purpose/Background: Preoperative frailty has been associated with adverse postoperative outcomes in various populations, but application of its use in patients with inflammatory bowel disease (IBD) remains sparse. The present study aimed to characterize the impact of frailty, as measured by the modified frailty index (mFI), on postoperative clinical and resource utilization outcomes in patients with IBD.Methods/Interventions: This retrospective population-based cohort study assessed patients from the National Inpatient Sample database from September 1st, 2015, to December 31st , 2019. Corresponding ICD-10 CM codes were used to identify adult patients (>18 years or age) with IBD, undergoing either small bowel resection, colectomy, or proctectomy. Patient demographics and institutional data were collected for each patient to calculate the 11-point mFI. Patients were categorized as either frail or robust using a cut-off of 0.27. Primary outcomes were postoperative in-hospital morbidity and mortality, while secondary outcomes included system-specific morbidity, length of stay (LOS), in-hospital healthcare costs, and discharge disposition. Logistic and linear regression models were used for primary and secondary outcomes.Results/Outcomes: Overall, 7,144 patients with IBD undergoing small bowel resection, colectomy, or proctectomy were identified, 337 of which were classified as frail (i.e., mFI < 0.27). Frail patients were more likely to be female, older, have lower income, and greater number of comorbidities. After adjusting for relevant covariates, frail patients were at greater odds of in-hospital mortality (adjusted odds ratio (aOR) -5.42, 95% CI 2.31-12.77, p < 0.001), overall morbidity (aOR 1.72, 95% CI 1.30-2.28, p < 0.001), LOS (adjusted mean difference (aMD) 1.3 days (95% CI 0.09 2.50, p=0.035), and less likely to be discharged to home (aOR 0.59, 95% CI 0.45-0.77, p < .001) compared to their robust counterparts.Conclusion/

Discussion: Frail IBD patients are at greater risk of postoperative mortality and morbidity, and reduced likelihood of discharge to home, following surgery. This has implications for clinicians designing care-pathways for IBD patients following surgery.