Bedard Katherine, Rajabali Naheed, Tandon Puneeta, Abraldes Juan G, Peerani Farhad
Department of Medicine, Faculty of Graduate Studies and Research, University of Alberta, Edmonton, Alberta, Canada.
Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada.
Gastro Hep Adv. 2022 Feb 3;1(2):241-250. doi: 10.1016/j.gastha.2021.11.009. eCollection 2022.
Chronological age often guides the management of patients with inflammatory bowel disease (IBD). Frailty and sarcopenia, which are related but distinct entities that become increasingly prevalent with age, better predict nonsurgical and surgical outcomes in various chronic illnesses. We conducted a systematic review to assess the association between frailty or sarcopenia and adverse nonsurgical outcomes in adult patients with IBD.
Through a systematic literature review of 4 online databases (MEDLINE, EMBASE, Scopus, and CINAHL Plus), we identified 16 studies that focused on frailty or sarcopenia and nonsurgical outcomes in IBD. The Newcastle-Ottawa Scale was used to determine the quality of included studies.
We identified 16 studies: 8 frailty-based and 8 sarcopenia-based studies (14 high-quality and 2 low-quality studies). All results were presented in a summarized narrative format. Frailty predicted all hospitalization-related outcomes (hospitalization, readmission, and length of stay) and mortality-related outcomes. The outcomes of therapeutic efficacy, need for therapy escalation, and infections had mixed results in relation to their association with frailty or sarcopenia. The data regarding sarcopenia and hospitalizations were also equivocal.
This systematic review supports the use of frailty indices to predict hospitalization- and mortality-related outcomes in adult patients with IBD. Future research should focus on identifying and validating frailty and sarcopenia tools in IBD to better help predict adverse clinical outcomes and response to therapy.
实际年龄常指导炎症性肠病（IBD）患者的管理。衰弱和肌肉减少症是相关但不同的实体，随着年龄增长愈发普遍，能更好地预测各种慢性疾病的非手术和手术结局。我们进行了一项系统评价，以评估衰弱或肌肉减少症与成年IBD患者非手术不良结局之间的关联。
通过对4个在线数据库（MEDLINE、EMBASE、Scopus和CINAHL Plus）进行系统文献回顾，我们确定了16项关注IBD中衰弱或肌肉减少症及非手术结局的研究。采用纽卡斯尔-渥太华量表来确定纳入研究的质量。
我们确定了16项研究：8项基于衰弱的研究和8项基于肌肉减少症的研究（14项高质量研究和2项低质量研究）。所有结果均以总结叙述形式呈现。衰弱可预测所有与住院相关的结局（住院、再入院和住院时间）以及与死亡率相关的结局。治疗效果、治疗升级需求和感染的结局与衰弱或肌肉减少症的关联结果不一。关于肌肉减少症与住院情况的数据也不明确。
这项系统评价支持使用衰弱指数来预测成年IBD患者与住院和死亡率相关的结局。未来的研究应聚焦于识别和验证IBD中的衰弱和肌肉减少症评估工具，以更好地帮助预测不良临床结局及对治疗的反应。
