P477 - PENDING MALNUTRITION IN IBD IS BETTER PREDICTED BY THE IBDMR SCORE

P477

PENDING MALNUTRITION IN IBD IS BETTER PREDICTED BY THE IBDMR SCORE

R. Moyal¹, N. Fliss-Isakov^2,3, N. Maharshak^1,3, R. Anbar⁴, L. Deutsch^1,3,*

¹School of Medicine, Faculty of Medical & Health Sciences, ²Department of Health promotions, School of Public Health, Faculty of Medical & Health Sciences, Tel-Aviv University, ³Department of Gastroenterology and Liver Diseases, ⁴Nutrition and Dietetics Department,, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

Rationale: Malnutrition worsens outcomes in inflammatory bowel disease (IBD). While screening is recommended, tools like the Malnutrition Universal Screening Tool (MUST) lack IBD-specific sensitivity, especially in outpatients with IBD. This study aimed to evaluate the predictive performance of MUST and IBD Malnutrition Risk (IBDMR) score for early nutritional decline in IBD.

Methods: We retrospectively analyzed a cohort of adult patients with Crohn’s disease, ulcerative colitis, or pouchitis who attended our tertiary IBD clinic for 2 visits, 6–12 months apart (2020-21), with baseline normo-nutrition status. Malnutrition risk was assessed at 1^st visit using the MUST and the IBDMR score—a composite of low BMI (18.5–22 kg/m²), mod-severe endoscopic disease activity, and high healthcare utilization. Follow-up outcomes included malnutrition (ESPEN criteria) and the novel “Pending Malnutrition”(PM), defined as BMI ≤20 kg/m² with ≥1-point decrease or ≥5% weight loss. Predictive performance of malnutrition or PM by both tools was evaluated by multivariate logistic regression.

Results: םut of 363 included patients, only 5/363 patients (1.4%, all females) developed malnutrition in 6-12 months, while 25/363 (6.9%) met PM criteria. PM compared to no-PM was associated with female sex(72% vs 48.8%, p=0.020), higher bowel movement frequency [median 6(1-20) vs 3(0.3-30)/day, p=0.009], and lower self-rated health (Good/very good 36% vs 54.8%, p=0.046) at baseline. A high IBDMR score was independently associated with PM (OR 7.41, p=0.017), as was increased daily bowel movements (OR 1.10, p=0.004). The MUST showed no predictive value (p=0.999).

Conclusion: The IBDMR score better predicts mild-moderate nutritional decline than MUST in ambulatory IBD patients. PM may serve as a practical early warning marker, especially in the ambulatory setting, to guide timely interventions, however, prospective validation is warranted.

Disclosure of Interest: None declared