Introduction: Patients with inflammatory bowel disease (IBD) are at risk of malnutrition given factors including protein enteropathy, impaired nutrient absorption, and increased metabolic demand during disease flares. The prevalence of malnutrition among outpatients with IBD is between 20-50%. Malnourished patients can develop sarcopenia, which is associated with increased need for surgery and postoperative complications. The primary aim of this study is to assess the feasibility of implementing malnutrition screening in IBD patients in GI clinics at a tertiary care center. Here we present preliminary findings and exploratory analysis from the proposed intervention. Methods: Patients in GI clinic at a tertiary care center between August and December 2022 with a diagnosis of ulcerative colitis (UC) or Crohn’s Disease (CD) were included. Patients were screened using the mMUST survey which includes BMI < 18.5, 5% weight loss within the past 6 months, and IBD flare with poor intake lasting > 5 days within 6 months. A point was assigned for the presence of each variable. Patients with mMUST > 1 were sent to a dietician for assessment including Body Impedance Analysis (BIA), hand grip strength, and nutritional history. Data was extracted via chart review. Exploratory analysis involved t-tests for comparison between numerical values and Fischer’s exact tests for categorical comparisons. Spearman’s correlation matrix was used due to small sample size. Results: Of 1629 eligible patients, 921 underwent mMUST screening. Of 40 patients with mMUST > 1, 19 patients completed dietician evaluation. Characteristics of these patients are displayed in Table 1. More patients with BMI ≤ 25 had muscle depletion (P = 0.003). Patients with BMI ≤ 25 had lower BIA fat mass and BIA percent body fat compared to those with BMI > 25 (P < 0.001). There were significant (P < 0.05) positive correlations between BIA body fat mass and BMI (P = 0.96) as well as hand grip and BIA skeletal muscle mass (P = 0.75). Conclusion: 56.5% of IBD patients were screened for malnutrition during the study, suggesting that standardized malnutrition screening is feasible. 81.25% of patients who completed the dietician evaluation had a BMI ≤ 25, which could indicate a role for education about malnutrition in overweight patients. Potential barriers to implementation identified include provider documentation, patient buy-in, and verbiage used by schedulers. Continued study with interventions to improve uptake is warranted. Table 1. - Characteristics of nineteen patients who completed mMUST screening as well as dietician evaluation. Units in number of patients per category unless otherwise denoted Total Patients BMI ≤ 25 BMI > 25 Crohn's Disease 13 9 4 Ulcerative Colitis 6 4 2 Mean Disease Duration (years) 13.47 ± 13.23 16.54 ± 14.79 6.83 ± 5.27 Current biologic or small molecule use 16 10 6 Steroid Use within 3 months 13 8 5 Disease flare within 3 months 17 11 6 History of surgery due to IBD 10 8 2 mMUST > 1 7 5 2 Daily nutritional intake < 75% needs 6 4 2
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