P205 Prevalence of anaemia in a nationwide cohort of elderly onset ulcerative colitis patients
D. Patel1, N. Khan*2
1Mercy Catholic Medical Centre, Internal Medicine, Philadelphia, Pennsylvania, United States, 2University of Pennsylvania, Internal Medicine, Philadelphia, Pennsylvania, United States
Anaemia is a commonly unrecognised complication of ulcerative colitis (UC). Elderly onset UC is a distinct clinical entity with its unique phenotype and disease course. There is a paucity of data on the prevalence of anaemia in elderly onset UC patients.
Aim: to assess the prevalence of anaemia in a nationwide population-based cohort of elderly onset UC patients and compare with adult-onset UC patients.
A previously validated cohort of newly diagnosed UC patients from the nationwide Veterans Affairs (VA) health care system was used as the study population. Charts of all patients were individually reviewed, and demographic and clinical data were collected. Anaemia was defined according to WHO criteria: in men as Hb < 13 g/dL, in non-pregnant women < 12 g/dL, and in pregnant women < 11 g/dL. Elderly onset UC was defined as onset of disease ≥ 60, and adult onset was defined as onset < 60. A retrospective cohort design and time-to-event survival analysis was used to track outcomes of interest. Differences between groups of categorical variables were measured using Chi square.
In total, 978 patients were included in analysis; 170 sites from 48 states and Puerto Rico were represented. Further, 435 (44.4%) patients had onset of UC after age of 60 years. The median age at diagnosis of UC in this cohort was 65 years (range 60–89 years). The median duration of follow-up was 8 years (range 1–13 years). The majority of patients were male and Caucasian. Moreover, 318 patients (73.1%) were diagnosed with anaemia over the course of their disease in this elderly onset UC cohort group. In addition, 543 patients (55.5%) had onset of UC before the age of 60 years. The median age at diagnosis of UC in this cohort was 49 years (range 21–59 years). The median duration of follow-up was 9 years (range 1–13 years). The majority of patients were male and Caucasian. In total, 334 patients (61.5%) were diagnosed with anaemia over the course of their disease in adult-onset UC cohort. Patients with age greater than 60 had 1.7 (CI 1.29 to 2.23, p-value 0.0001)-times odds of having anaemia compared with patients with age of less than 60 years.
In this nationwide cohort, more than two thirds of patients with elderly onset UC developed anaemia over the course of disease. Anaemia was more common in elderly onset UC than adult-onset UC. This rate is higher than any previously reported studies evaluating anaemia in IBD patients, and physicians should be cognisant of this while treating elderly patients.