Frailty triples risk of death in IBD patients

Frailty is common in patients with inflammatory bowel disease (IBD), with the prevalence increasing with age, and is associated with a threefold higher likelihood of death, a study has found.

The study included a cohort of 11,001 IBD patients (median age, 46 years; 53 percent female), among whom 675 (6 percent) had a frailty‐related diagnosis. Frailty prevalence increased with age, jumping from 4 percent in the 20–29-year age group to 25 percent of those in the 90-year age group.

The first leading cause of frailty was protein‐energy malnutrition (74 percent), followed by walking difficulty (20 percent) and unspecified protein calorie malnutrition (8 percent).

Compared with fit patients, those who were frail were significantly older (53  vs 46 years), had higher comorbidity index (6 vs 1), more likely to have undergone an IBD-related surgery (32 percent vs 11 percent), and more commonly treated with corticosteroids (61 percent vs 35 percent), immunomodulators (31 percent vs 24 percent) or antitumour necrosis factor (anti‐TNF) agents (17 percent vs 11 percent).

The strongest predictors of frailty were a higher number of comorbidities (odds ratio [OR], 17.31, 95 percent confidence interval [CI], 8.14–36.79) and all‐cause (OR, 7.67, 95 percent CI, 4.62–12.73) and IBD‐related hospitalization (OR, 2.29, 95 percent CI, 1.85–2.83). There was no association seen for gender, immunomodulator use, and anti‐TNF use.

Of note, frail IBD patients were more likely to die than their fit counterparts (21 percent vs 6 percent; OR, 4.00, 95 percent CI, 3.28–4.89; p<0.001). This observation persisted despite adjustments for potential confounders (adjusted OR, 2.90, 95 percent CI, 2.29–3.68). There was no significant between-group difference in the median time to death.

Given the rising burden of IBD in older adults, researchers underscored the importance of systematically and prospectively investigating frailty in IBD to determine appropriate interventions.