Abstract
Background: Anemia is a common manifestation of inflammatory bowel disease (IBD) with an important impact on patients' quality of life. We prospectively evaluated patterns of anemia over time as a marker of disease severity in a large cohort of IBD patients. Methods:We analyzed demographic, clinical, laboratory and treatment data from a prospective, consented longitudinal IBD natural history registry for the years 2009-2013. Patients with a complete follow-up (at least one annual visit with laboratory results) were included. Anemia was defined based on the World Health Organization (WHO) criteria. Disease activity scores (Harvey-Bradshaw Index or ulcerative colitis activity index) and quality of life score [short IBD questionnaire (SIBDQ)] completed at each visit, laboratory data including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as well as patterns of IBD related health care utilization were analyzed. The average values of the 5-year measurements were calculated and used in the analysis. Results: A total of 410 IBD patients (245 with Crohn's disease, 165 with ulcerative colitis, 50.5 % females) were included. The prevalence of anemia in IBD patients per year is presented in Figure 1. The anemia status of the IBD patients was significantly correlated with CRP (r=0.37, p 0.05). IBD patients with persistent anemia (N:133, anemia ≥3 years) had significantly higher health care use and higher indices of disease activity, as well as lower average quality of life compared to patients with transient anemia (N:140, anemia 1-2 years) or without anemia (N:137) (p 3 years) may serve as an important marker of severity and worse clinical course in patients with IBD. Validation of persistent anemia as a marker of disease severity in other IBD tertiary or population-based cohorts is warranted. Determinants of persistent anemia in inflammatory bowel disease patients in the adjusted analysis
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