S1863 Impact of Sarcopenia on Inpatient Outcomes Among Patients Hospitalized With Inflammatory Bowel Disease: A Five-Year Nationwide Analysis

Introduction: Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, is increasingly acknowledged in chronic inflammatory conditions like inflammatory bowel disease (IBD). Our objective was to assess the association between sarcopenia and inpatient outcomes among IBD patients utilizing data from a national database. Methods: We conducted a retrospective cohort study utilizing 5 years of data from the National Inpatient Sample (2017–2022). Our analysis focused on adult hospitalizations with a primary or secondary diagnosis of inflammatory bowel disease (Crohn’s disease and ulcerative colitis) that also included a diagnosis of sarcopenia. We identified cases using a comprehensive array of diagnostic codes. To evaluate the associations with inpatient mortality, infections, ICU stays (approximated through mechanical ventilation), major IBD-related surgeries, venous thromboembolism (VTE), length of stay (LOS), and total hospital charges, we employed multivariable logistic and linear regression models. The analysis was conducted using STATA 18. Results: From a weighted total of 1,591,464 IBD-related hospitalizations, 2.8% had co-diagnosed sarcopenia. Compared to non-sarcopenic patients, sarcopenic IBD patients had significantly higher odds of mortality [aOR 2.10 (95% CI 1.89–2.34)], infections [aOR 1.14 (95% CI 1.05–1.24)], ICU stay [aOR 1.24 (95% CI 1.12–1.38)]. They also had more extended hospital stays (mean difference +0.92 days, P < 0.001) and higher total charges (+$3,849, P = 0.024). Sarcopenia reduced the odds of undergoing major IBD-related surgery in this cohort [aOR 0.71 (95% CI 0.64–0.79)] but had no significant difference in development of VTE [aOR 1.09 (95% CI 0.99-1.20)]. Sensitivity analysis using a strict sarcopenia definition yielded consistent but non-significant trends. Subgroup analysis showed that sarcopenic patients with obesity had similar mortality and infection outcomes compared to those without obesity. Conclusion: Sarcopenia is independently linked to poorer inpatient outcomes and increased healthcare utilization in hospitalized patients with inflammatory bowel disease. The lower likelihood of requiring major IBD-related surgeries in this population may indicate underlying frailty and heightened surgical risk. It may be beneficial to implement routine screening and targeted interventions for sarcopenia, such as nutritional support and physical therapy, to enhance clinical outcomes within this group.