P188 Evaluation of Global Leadership Initiative on Malnutrition (GLIM) criteria for the diagnosis of malnutrition in patients affected by inflammatory bowel disease (IBD) candidates for elective surgery

Abstract

In inflammatory bowel disease (IBD), malnutrition has been associated with increased postoperative complications incidence, longer hospital stay and higher costs. ESPEN guidelines recommend that all IBD patien ts must be screened for malnutrition. Recently, so-called GLIM criteri a were developed to uniform malnutrition diagnosis. Our aim was to det ermine the prevalence of malnutrition comparing the different malnutri tion criteria. The nutritional status of all IBD patients’ candidates to surgery in our Centre during 2019 was assessed. According to the GLIM criteria, t he diagnosis of malnutrition is based on the presence of almost one ph enotypic criteria (non-volitional weight loss, low body mass index and reduced muscle mass) and almost one aetiologic criteria (reduced food intake or assimilation; biochemical inflammation). The results were c ompared with that found adopting ESPEN 2015 criteria for malnutrition to evaluate their concordance. Fifty-three consecutive IBD patients [38 Crohn’s disease (CD) and 15 ulcerative colitis (UC)] were evaluated. The average values of Body Ma ss Index, Free Fat Mass Index ad Phase Angle were 22.69 kg/m2, 17.6 kg /m2 and 5.8° respectively. According to the Nutritional Risk Screening (NRS) test 40% (21 patients) of patients were at high nutritional ris k. Forty-five per cent (24 patients) were malnourished according to GL IM criteria (14 with severe malnutrition and 10 with moderate malnutri tion), while according to the ESPEN criteria only 26% (14 patients) (T able 1). The correlation between GLIM and ESPEN, calculated with the C ohen’s kappa coefficient (k) was moderate/good (k 0,605). GLIM criteria indicate higher prevalence of malnutrition than ESPEN c riteria. Interestingly, the same 14 patients malnourished for ESPEN ha ve severe malnutrition (Stage 2) according to GLIM. Furthermore, seven malnourished patients according to GLIM criteria are not considered a t nutritional risk according to NRS, probably because it does not cons ider the muscle mass loss. Patients with CD have a higher prevalence o f aetiological factors, while UC patients have a higher prevalence of phenotypic factors. Malnutrition prevalence was higher in UC probably due to the ileostomy present before second-stage surgery 4 months afte r subtotal colectomy in acute severe cases. The concordance between GL IM and ESPEN 2015 appears moderate/good.