P0704Optimizing malnutrition risk detection in Inflammatory Bowel Disease: a longitudinal analysis of serial nutritional screening tools

Abstract Background Malnutrition remains a significant and under-recognized complication in patients with Inflammatory Bowel Disease (IBD), even during periods of clinical remission, impacting clinical outcomes and quality of life. While systematic nutritional screening is recommended, comparative evidence supporting specific tools and screening strategies is limited. This prospective, longitudinal study evaluates the diagnostic performance of five commonly used nutritional screening tools (NSTs) when serially administered to IBD outpatients in sustained clinical remission, addressing the critical question of whether repeated assessments enhance malnutrition risk detection over time. Methods In this prospective, single-center cohort study, NSTs was administered to and body composition analysis (BIA) performed in IBD patients in sustained clinical remission at baseline and after six months (T1). The diagnostic performance of baseline NSTs (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) to identify malnourished patients defined by ESPEN and GLIM criteria, was evaluated at baseline and at 6 months. The performance of repeated administration of NSTs over time was compared against single-point assessments. A sensitivity analysis using low fat-free mass index (FFMI) as an objective reference standard was also performed. Results Sixty-six IBD patients in sustained clinical remission (32 Crohn’s disease; 34 ulcerative colitis) were enrolled. Demographics and disease characteristics are reported in Table1. At baseline, 25.7% and 9% of patients were malnourished according to ESPEN and GLIM criteria, respectively, with 7.5% exhibiting low FFMI. Malnutrition prevalence increased over time to 53%, 16.6%, and 16.6%, respectively. Among NSTs, MUST and SaskIBD-NR consistently exhibited the highest specificity for malnutrition detection at baseline, at 6 months, as well as for the detection of patients persistently malnourished, independently of the definition used (ESPEN, GLIM, or low FFMI). Serially repeated NSTs administration markedly improved the specificity of all tools, compared to single-point assessments. Figure 1 Conclusion Serial nutritional screening with MUST or SaskIBD-NR significantly enhances specificity for detecting malnutrition risk in IBD patients in remission. These findings provide new evidence supporting the incorporation of repeated nutritional assessments into routine clinical practice and offer a practical strategy for improving the accuracy and efficiency of malnutrition screening in IBD outpatient care, ensuring earlier identification of at-risk patients and ultimately contributing to improved health outcomes in IBD management. References: 1. Nguyen GC, Munsell M, Harris ML. Nationwide prevalence and prognostic significance of clinically diagnosable protein-calorie malnutrition in hospitalized inflammatory bowel disease patients: Inflammatory Bowel Diseases. 2008;14(8):1105-1111. doi:10.1002/ibd.20429 2. Kinnucan J, Binion D, Cross R, et al. Inflammatory Bowel Disease Care Referral Pathway. Gastroenterology. 2019;157(1):242-254.e6. doi:10.1053/j.gastro.2019.03.064 3. Van Bokhorst-de Van Der Schueren MAE, Guaitoli PR, Jansma EP, De Vet HCW. Nutrition screening tools: Does one size fit all? A systematic review of screening tools for the hospital setting. Clinical Nutrition. 2014;33(1):39-58. doi:10.1016/j.clnu.2013.04.008 4. Zhang C, Yu D, Hong L, et al. Prevalence of Sarcopenia and Its Effect on Postoperative Complications in Patients with Crohn’s Disease. Günay S, ed. Gastroenterology Research and Practice. 2021;2021:1-8. doi:10.1155/2021/3267201 Conflict of interest: Dr. Favale, Agnese: Advisory board for AbbVie Orrù, Valentina: No conflict of interest Di Petrillo, Amalia: No conflict of interest Lutzu, Nicola: No conflict of interest Olla, Federica: No conflict of interest Onnis, Francesca: No conflict of interest Piras, Raffaela: No conflict of interest Demurtas, Mauro: No conflict of interest Ibba, Ivan: No conflict of interest Italia, Angelo: No conflict of interest Fantini, Massimo Claudio: MCF has acted as a consultant for: AbbVie, AlfaSigma, Celgene, Celltrion, Gilead, Pfizer, MSD, Bristol-Meyer, Takeda, Johnson & Johnson, Roche, Galapagos, Biogen, Sandoz, Eli-Lilly, Lionhealth, Teva, Giuliani, Dr Falk Pharma, Sanofi he has received financial support for research from Johnson & Johnson and Pfizer. Onali, Sara: Consultant/lecture fees to: Abbvie, Alfasigma, MSD, Takeda, J & J, Galapagos, Pfizer, Eli Lilly