Effect of Anemia on Health Related Quality of Life in Pediatric Inflammatory Bowel Disease: Comparison of a Single Center Cohort to Published Data

Abstract

Background: Health related quality of life (HRQL) is a key outcome measure, increasingly used to evaluate the efficacy of medical interventions. While anemia is the most common systemic complication of inflammatory bowel disease (IBD) in children, the literature is scarce on its effect on HRQL. Aim: Evaluation of the association between anemia and HRQL in children with IBD. Methods: PedsQL 4.0, a generic HRQL survey that assesses subjective perception of psychosocial and physical well-being from patient and parental perspective was administered to 30 children with IBD. Results were analyzed in patients with and without anemia, and with active and quiescent disease. Findings were compared to published data in pediatric IBD and healthy controls. Anemia was defined by WHO criteria. Active disease was defined by pediatric Crohn’s disease or ulcerative colitis indices >10 and/or low albumin or elevated CRP. Results: Within our cohort as a whole and among our patients in remission, anemia was associated with lower mean scores in multiple domains of the PedsQL 4.0 survey. Similarly, in these groups a higher proportion of patients had abnormal scores. Compared to published pediatric IBD data, our patients in remission with normal hemoglobin scored significantly higher in all HRQL domains, while there was no significant difference between the two cohorts as a whole. Compared to healthy controls our cohort as a whole and patients with anemia scored significantly lower in all parent-reported domains. In contrast, scores in patients with normal hemoglobin were not significantly different from healthy controls. Conclusions: Anemia was associated with impaired HRQL in children with IBD including those in apparent remission.