P248 Prevalence of testing and impact of severity of anaemia on testing for iron deficiency in a nationwide cohort of anaemic ulcerative colitis patients
D. Patel*1, N. Khan2
1Mercy Catholic Medical Centre, Internal Medicine, Philadelphia, United States, 2University of Pennsylvania, Internal Medicine, Philadelphia, Pennsylvania, United States
Anaemia is a common and frequently under investigated complication of ulcerative colitis (UC). Iron deficiency is the most common cause of anaemia in UC. There is paucity of data on the frequency of testing for iron deficiency in anaemic patients with UC.
Aim: to evaluate the frequency of testing for iron deficiency in anaemic patients with UC and determine the effect of anaemia severity of testing.
A previously validated nationwide cohort from the Veterans Affairs (VA) health care system of newly diagnosed UC patients was used as the study population. Anaemia was defined according to WHO criteria: in men as Hb <13 g/dL, in non-pregnant women <v12 g/dL, and in pregnant women <1v1 g/dL. Similarly as per WHO classification, patients with anaemia were subdivided into 3 groups depending on their Hb level: Mild (Hb 11–13 g/dL in male and 11–12 g/dL in female), moderate (Hb 8–11 g/dL in both sexes) and severe (Hb <8 g/dL in both sexes). Charts of all patients were individually reviewed, and demographic and clinical data were collected. All patients with anaemia were reviewed for iron deficiency. Evaluation of iron deficiency was defined as checking ferritin and/or transferrin saturation at the time of diagnosis of anaemia. A retrospective cohort design and time-to-event survival analysis was used to track outcomes of interest. Difference between groups of categorical variables was measured using Chi square.
In total, 978 patients were included in analysis, and 170 sites from 48 states and Puerto Rico were represented. Further, 652 patients (66.6%) were diagnosed with anaemia during their course of disease. Of 652 patients, 232 patients (35.5%) had mild anaemia, 309 patients (47.3%) had moderate anaemia, and 111 patients (17%) had severe anaemia. Of 652 patients, 445 patients (68.2%) were evaluated for iron deficiency at the time of diagnosis of anaemia. Iron studies were performed in 110/232 patients (47.4%) with mild anaemia, 233/309 patients (75.4%) with moderate anaemia, and 102/111 patients (91.8%) with severe anaemia. The odds of having evaluation for Iron deficiency anaemia were 7.89 (CI 4.74 to 13.14, p-value < 0.001)-times higher in the group with haemoglobin less than 9 when compared with the group with haemoglobin of 11–13.
Almost half of the patients with mild anaemia in setting of UC were not evaluated for iron deficiency. Evaluation of causes of anaemia should be included as a quality measure for ulcerative colitis patients.