Clinical Research Studies

We will conduct a prospective cohort study of 120 patients at NYU Langone. Patients who have a biopsy confirmed diagnosis of IBD, who are = 18 years-old, who are undergoing disease-related intestinal resection at NYU Langone Health, and have had CT imaging within 90 days of surgery, will be eligible for study inclusion. Patients who are seen at our outpatient NYU IBD surgical clinics or preoperatively in the hospital, and are planned for intestinal resection, will be approached by their physician to gauge interest in study participation. Patients will receive $25 for their time, with a plan to enroll 120 adults with IBD. Sarcopenia Measures: In accordance with guidelines from the EWGSOP and FNIH Sarcopenia Project, our prospective assessment of sarcopenia will include both measures of muscle strength and mass. Muscle strength will be evaluated through grip strength using a standardized Jamar dynamometer, whereby three measurements will be taken from each hand and with a chair stand. Muscle mass will be determined using the cross-sectional imaging measure found to be most predictive of postoperative outcomes. Cognitive assessment will also be performed using a MOCA questionnaire upon initial assessment. On initial study visit, participants will be asked relevant demographic information including age, sex, smoking status (never, former, current), prior abdominal surgery, as well as race and ethnicity. Body mass index (BMI) will be taken at the time of visit, and comorbidities from the Charlson Comorbidity Index will be obtained from the EHR with patients categorized as having 0, 1, =2 comorbidities. IBD-specific variables including: (1) preoperative use of corticosteroids, immunomodulators (IMM) and/or biologics, (2) presence of preoperative infection/abscess, (3) preoperative use of exclusive enteral or parenteral nutrition, and (4) elective or emergent status of the procedure will be extracted from the EHR. Disease severity will be obtained at the time of initial study visit, using validated questionnaires for both CD and UC. For CD, severity will obtained using the validated Harvey Bradshaw Index with scores <5 indicating remission, 5-7 mild disease, 8-16 moderate disease, and >16 severe disease. For UC, disease severity will be obtained using the validated Mayo score, with <3 indicating remission, 3-5 mild disease, 6-10 moderate disease, >10 severe disease. Primary Outcome: 30-day composite of postoperative mortality and major complications, including infection, bleeding (requiring blood transfusion or requiring intervention), cardiac event (myocardial infarction, arrhythmia, and cardiac arrest), stroke, acute kidney injury (increase in serum creatinine of =0.3 mg/dL from baseline or =1.5 times baseline), venous thromboembolism, reoperation, readmission, and need for ICU-level care. Outcome measures will be obtained from the electronic health record (HER). We plan to reach enrollment over two years given preliminary surgical numbrrs from NYU IBD surgical clinic (620 unique patient surgeres over prior 5 years).