Table 3.
Studies on frailty in patients with inflammatory bowel disease
| Author and year | Study population | Number | Frailty measures | Prevalence of frailty | Outcome | OR/RR/HR and P value |
|---|---|---|---|---|---|---|
| Wolf et al., 2021 28 | CD with bowel resections | 9023 | Simplified frailty index (sFI) | sFI ≥1 in 1610 (17.8%) | Higher sFI (≥2) is associated with | |
| morbidity (OR) | 2.59 (P < 0.001) | |||||
| malnutrition | P < 0.01 | |||||
| emergency surgery | P < 0.01 | |||||
| Telemi BS et al., 2018 29 | UC with colectomy, frailty as a predictor (OR) | 943 | Modified frailty index (mFI) |
mFI of 0.09: 184 (19.5%) mFI ≥0.18: 121 (12.8%) |
Complications (OR) | |
| Septic | 31.26 (P:0.006) | |||||
| Cardiopulmonary | 216.3 (P < 0.001) | |||||
| Clavien class IV | 204.9 (P < 0.001) | |||||
|
Morbidity (OR) | ||||||
|
Overall |
25.5 (P < 0.001) | |||||
| serious | 66.8 (P < 0.001) | |||||
| Cohan J et al., 2015 30 | UC with colectomy and IPAA | 2493 | Frailty trait count | NA | Mean number of complications | 0.31 vs. 0.34, P: 0.36 |
| Length of hospital stay | 7.4 vs. 7.7 days, P: 0.25 | |||||
| Faye S et al. 31 | Admitted IBD |
UC—510 199 (36%) CD—888 981 (63%) |
ICD‐9‐CM codes from Johns Hopkins clinical groups frailty | 152 974 (10.9%) | Increased risk of readmission (RR) | 1.16 (1.14–1.17) |
| Increased risk of readmission (RR) mortality in CD | 1.32 (1.13–1.55) | |||||
| Qian S et al., 2021 32 | Admitted IBD | 47,402 | Hospital frailty risk score |
15 507 (32.7%) Medium frailty—14 207 High frailty—1480 |
IBD‐related severe hospitalizations (HR) | 1.22 (1.16–1.29) |
| Higher readmission rates (HR) | 1.21 (1.17–1.25) | |||||
| Higher inpatient mortality (HR) | 1.57 (1.34–1.83) | |||||
| Kochar B et al., 2020 20 |
Admitted IBD on predictors of frailty |
11 001 | Based on ICD‐10 codes | 675 (6%) |
≥1 comorbidities (CCI) |
17.31 (8.14–36.79) |
|
Hospitalization All cause IBD related |
7.67 (4.62–12.73) 2.29 (1.85–2.83) |
|||||
| Kochar B et al., 2022 25 | On response of frailty to anti‐TNF, predictors of post treatment frailty |
1210 CD: 71% UC: 29% |
Claims‐based frailty index (CFI) | 189 (15.6%) | Pretreatment frailty (OR) | 2.10 (1.35–3) |
| IBD‐related hospitalization (OR) | 1.63 (1.15–2.3) | |||||
| Singh S et al., 2020 24 | Risk of infections in patients on biologicals | 5987 IBD | Hospital frailty risk score | 2350 (39.3%) | Risk of serious infections (HR) | |
| Anti TNF α | 1.03 (0.83–1.27) | |||||
| Vedolizumab | 1.69 (1.03–2.79) | |||||
| Gondal et al., 2020 21 | Mortality and disease activity in IBD |
2978 IBD UC: 53.5% CD: 46% Indeterminate: 0.5% |
Frailty index (score > 0.27) | 953 (32%) | Mortality (OR) | 1.52 (1.07–2.16) |
| >5 IBD flares (OR) | 1.2 (0.99–1.45) | |||||
| Salvatori S et al., 2023 22 | Prospective cohort | 64 with IBD and frailty | Fried frailty score | Median 8‐month follow‐up | Extraintestinal manifestations (OR) | 0.1 (0.02–0.8) |
| Clinically active disease (OR) | 0.1 (0.01–0.6) | |||||
| Biological use (OR) | 21.7 (3.4–263) | |||||
| Asscher et al., 2022 23 | Prospective multicenter study on IBD factors associated with geriatric deficits |
405 IBD CD: 191 UC: 202 IBD‐UC: 12 |
Geriatric assessment |
Moderate deficits: 160 (39.5%) Severe deficits: 32 (7.9%) |
Crohn's disease (OR) | 1.799 (1.179–2.743) |
| Clinical disease activity (OR) | 2.192 (1.284–3.743) | |||||
| Fecal calprotectin (OR) | 2.721 (1.376–5.379) | |||||
| Previous all‐cause hospitalization (OR) | 1.994 (1.267–3.137) | |||||
| Kochar et al., 2020 27 | Retrospective study on patients being initiated on biologicals and immunomodulators | 1299 on anti‐TNF and 2676 on immunomodulator | Frailty risk score (ICD‐10) |
Anti‐TNF: 68 (5.2%) Immunomodulator: 212 (7.9%) |
Risk of infection on anti‐TNF (OR) | 2.05 (1.07–3.93) |
| Risk of infection on Immunomodulator (OR) | 1.81 (1.22–2.70) | |||||
Anti‐TNF, anti‐tumor necrosis factor; CD, Crohn's disease; CFI, Claims‐based frailty index; HR, hazard ratio; IBD, inflammatory bowel disease; IBD‐UC, inflammatory bowel disease‐unclassified; ICD, international classification of diseases; IPAA, ileal pouch‐anal anastomosis; mFI, modified frailty index; OR, odds ratio; RR, risk ratio; sFI, simplified frailty index, UC, ulcerative colitis.