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P200. Is anemia a prognostic factor for disease behavior in IBD? - A Romanian National Register based evidence study

A. Lupu1, C. Cijevschi2, C. Mihai2, R. Iacob1, L. Gheorghe1, D. Dobru3, A. Tantau4, A. Goldis5, M. Ilie6, C. Gheorghe1, M. Ciocirlan1, M. Diculescu1, on behalf of the IBDPROSPECT Study Group, 1Fundeni Clinical Institute, Digestive Diseases and Liver Transplantation Center, Bucharest, Romania, 2Institute of Gastroenterology and Hepatology, Bd. Independentei, no. 1, Gastroenterology and Hepatology, Iasi, Romania, 3Municipal Hospital Targu Mures, Gastroenterology, Targu Mures, Romania, 43rd Medical Clinic Cluj-Napoca, Gastroenterology, Cluj-Napoca, Romania, 5University of Medicine ‘Victor Babes’, Clinic of Gastroenterology, Timisoara, Romania, 6Floreasca Emergency Hospital, Gastroenterology, Bucharest, Romania

Background

Anemia is a common complication of inflammatory bowel diseases (IBD) and it frequently increases morbidity in this group of patients; anemia can lead to prolonged hospitalisation, and somethimes agressive treatment, iron suplementation and even blood transfusions. Thus the need to better identify the epidemiologic, etiologic and therapeutic aspects of this condition. Aim: we have reviewed IBDProspect in order to better understand this complication.

Methods

We included 891 patients from IBDProspect that were enroled in 13 centers around the country from January 2006 to October 2013. We defined anemia as a hemoglobin (Hb) <12 g/dl and a hematocrit (Ht) <36% for women, and a Hb <13 (Ht <39%) for men.

Results

43.66% of the patients had anemia (71.47% women and 28.53% men). In the anemia group 43.44% had Crohn's disease (CD), 50.90% ulcerative colitis (UC) and 5.66% undetermined colitis. There was no significant statistical difference in phenotype between the anemic and non-anemic groups. We observed a statistically significant association between fistulising CD (17.82%) and anemia (p = 0.0127). Ileal location (L1) was significantly associated with normal Hb levels (p = 0.0141) and ileo-colonic extension (L3) with anemia (p = 0.0031). Extensive colitis (E3) was associated with low Hb levels in 44.95% of patients compared to 19.61% in the non-anemic group, with a statistically significant difference (p < 0.0001).

Conclusion

anemia is a frequent condition in IBD patients from Romania and could be considered a negative prognostic factor associated with extensive colonic lesions in UC and penetrating pattern in CD that requires close follow up and treatment.