Frailty Is Associated With All-Cause and Acute Hospitalisations During 18 Months Follow-Up in Older Patients With Inflammatory Bowel Disease

Background: Guidelines recommend considering frailty in the management of older patients with Inflammatory Bowel Disease (IBD). A geriatric assessment is a specific and clinically applicable frailty assessment tool that could potentially predict both adverse outcomes and inform treatment decisions in older patients with IBD. Aims: To examine the association of frailty with hospitalisations and mortality in older patients with IBD during 18 months follow-up. Methods: This is a prospective, multicentre cohort study in older patients (age ≥ 65 years) with IBD. Frailty was measured using a geriatric assessment, covering five domains of functioning. Deficits in geriatric assessment reflect the level of frailty and were defined as: no deficits (0–1 impaired domains), moderate deficits (2–3 impaired domains) and severe deficits (4–5 impaired domains). Follow-up was aimed at after 18 months. Outcomes were all-cause, acute and IBD-related hospitalisation and mortality. Analyses were adjusted for age, sex and biochemical disease activity (C-reactive protein ≥ 10 mg/L and/or faecal calprotectin ≥ 250 μg/g). Results: Of 405 patients with median age 70 years, 160 (39.5%) had 2–3 geriatric deficits, 32 (7.9%) had 4–5 geriatric deficits. Severe deficits were independently associated with both all-cause (adjusted hazard ratio [aHR] 3.46, 95% confidence interval [CI] 1.67–7.16) and acute hospitalisations (aHR 3.45, 95% CI 1.59–7.51). Specifically, an impaired somatic domain was independently associated with all-cause hospitalisations (aHR 2.13, 95% CI 1.32–3.42) and acute hospitalisations (aHR 2.43, 95% CI 1.40–4.22). Conclusions: Frailty, reflected by severe deficits in geriatric assessment, is independently associated with all-cause and acute hospitalisations in older patients with IBD.