Increased Mortality Associated With Sarcopenia in Inflammatory Bowel Disease: A Long-Term Prospective Cohort Study.

Abstract

Introduction: With gradually increasing number of older patients with inflammatory bowel disease (IBD), a significant number of patients with IBD suffer from sarcopenia. Emerging evidence has demonstrated various adverse outcomes associated with sarcopenia; however, the impact of sarcopenia on long-term mortality risk among patients with IBD has not yet been explored.

Methods: Overall, 4,966 patients with IBD (aged 56.9 ± 8.0 years, 51.6% female) were enrolled in the prospective cohort. Sarcopenia was assessed according to criteria of the European Working Group on Sarcopenia in Older People 2. The primary outcome was all-cause mortality. Multivariable Cox proportional hazard model was conducted to estimate related associations. Sensitivity analysis and subgroup analysis were used to validate the results.

Results: Overall, 775 (14.6%) and 34 (0.7%) were considered probable sarcopenia and confirmed sarcopenia, respectively. During a median follow-up of 14.6 years, 564 all-cause deaths (11.4%) were identified. There were 136 deaths (17.5%) among those with probable sarcopenia and 10 deaths (29.4%) among those with confirmed sarcopenia. Compared with nonsarcopenia, those with probable sarcopenia and confirmed sarcopenia had a 47% (hazard ratio = 1.47, 95% confidence interval: 1.20-1.80, P < 0.001) and 140% (hazard ratio = 2.40, 95% confidence interval: 1.27-4.52, P = 0.007) excess risk of mortality, respectively. Similar results were observed in sensitivity analysis.

Discussion: Probable and confirmed sarcopenia increase the risk of long-term mortality in patients with IBD. Sarcopenia assessment can help risk stratification for prognosis in older patients with IBD.