The impact of malnutrition on clinical outcomes in patients with perianal fistulizing Crohn's disease undergoing seton placement: A retrospective study.

IF 2.7 4区医学 Q3 NUTRITION & DIETETICS

Nutrition in Clinical Practice Pub Date : 2026-09-22 DOI:10.1002/ncp.70182

Bruno Augusto Alves Martins, Oswaldo de Moraes Filho, Tuane Colles, Clíslian Silva, Gabriela de Oliveira Lemos, Dannilo Brito Silveira, Heitor Siqueira Ribeiro, João Batista de Sousa

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引用次数: 0

Abstract

Background: Perianal involvement occurs in up to 50% of patients with Crohn's disease (CD). Despite combined management, 10%-20% require fecal diversion or proctectomy. Nutritional status may influence prognosis, but its role in fistulizing perianal disease is unclear. This study examines the impact of malnutrition on clinical outcomes in patients with perianal fistulizing CD.

Methods: A retrospective cohort study was conducted. Clinical data were collected from the health records of patients with perianal CD at two centers from January 2010 to December 2022. Nutritional screening followed Nutrition Risk Screening-2002. Patients with a score ≥3 were evaluated for malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria. The prevalence of malnutrition and its association with the risk of adverse clinical outcomes were analyzed.

Results: Of 64 patients, 17 (26.6%) had malnutrition. Malnourished patients had higher proctitis rates (100% vs. 78.7%, P = 0.038), lower serum albumin (3.47 vs. 3.97 g/dL, P = 0.002), and lower hemoglobin (10.9 vs. 12.5 g/dL, P = 0.003). They were younger at diagnosis (24.2 vs. 30 years, P = 0.046), had lower body mass indices (19.7 vs. 24.9 kg/m², P < 0.001), higher Harvey-Bradshaw index (10 vs. 5, P < 0.001), and more corticosteroid use (29.4% vs. 4.3%, P = 0.012). Malnourished patients had lower fistula healing (17.6% vs. 44.7%, P = 0.048), more proctectomies (47.1% vs. 14.9%, P = 0.007), and were more likely to undergo abdominal surgery (70.6% vs. 38.3%, P = 0.022). In the prespecified parsimonious multivariable model, malnutrition was significantly associated with proctectomy (aOR 4.478; 95% CI: 1.227-16.343; P = 0.023).

Conclusion: Malnutrition is a significant clinical risk marker associated with the requirement for proctectomy in patients with perianal fistulizing CD who undergo seton placement.

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营养不良对肛周瘘管性克罗恩病行塞顿置入术患者临床结果的影响：一项回顾性研究。

背景：高达50%的克罗恩病（CD）患者发生肛周受累。尽管联合治疗，仍有10%-20%需要大便转移或直肠切除术。营养状况可能影响预后，但其在瘘管性肛周疾病中的作用尚不清楚。本研究探讨营养不良对肛瘘患者临床预后的影响。方法：回顾性队列研究。临床资料收集自2010年1月至2022年12月两个中心的肛周CD患者的健康记录。营养筛查遵循2002年营养风险筛查。评分≥3分的患者使用全球营养不良领导倡议（GLIM）标准评估营养不良。分析了营养不良的发生率及其与不良临床结果风险的关系。结果：64例患者中有17例（26.6%）出现营养不良。营养不良患者的直肠炎发生率较高（100% vs. 78.7%, P = 0.038），血清白蛋白较低（3.47 vs. 3.97 g/dL, P = 0.002），血红蛋白较低（10.9 vs. 12.5 g/dL, P = 0.003）。他们在诊断时更年轻（24.2 vs. 30岁，P = 0.046），体重指数更低（19.7 vs. 24.9 kg/m2， P）。结论：营养不良是肛管周围瘘性CD患者行直肠切除术的重要临床风险标志。

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来源期刊

Nutrition in Clinical Practice 医学-营养学

CiteScore

6.00

自引率

9.70%

发文量

128

审稿时长

3 months

期刊介绍： NCP is a peer-reviewed, interdisciplinary publication that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. This journal is a member of the Committee on Publication Ethics (COPE).