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J Crohns Colitis. 2017 Oct 1;11(10):1213-1222. doi: 10.1093/ecco-jcc/jjx077.

Occurrence of Anaemia in the First Year of Inflammatory Bowel Disease in a European Population-based Inception Cohort-An ECCO-EpiCom Study.

Author information

1
Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark.
2
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
3
1st Division of Internal Medicine and Hepato-Gastroenterology Unit, University Hospital, Ioannina, Greece.
4
Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania.
5
Department of Gastroenterology, Adelaide and Meath Hospital, TCD, Dublin, Ireland.
6
Department of Gastroenterology. POVISA Hospital, Vigo, Spain.
7
Department of Gastroenterology. Instituto de Investigación Sanitaria Galicia Sur, Estrutura Organizativa de Xestión Integrada de Vigo, Vigo, Spain.
8
IBD Unit, Hull & East Yorkshire NHS Trust, Hull, UK.
9
Gastroenterology Department, Slagelse Hospital, Slagelse, Denmark.
10
Medical Department, National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
11
Department of Gastroenterology and Hepatology, Soroka Medical Center and Ben Gurion University of the Negev, Beer Sheva, Israel.
12
Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
13
Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.
14
Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
15
Division of Gastroenterology and Hepatology, University Hospital Center Zagreb,Zagreb, Croatia.
16
Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
17
IBD Clinical and Research Centre ISCARE, Charles University, Prague, Czech Republic.
18
Institute of Pharmacology, 1st Medical Faculty, Charles University, Prague, Czech Republic.
19
Gastroenterology Department, Hospital Ceské Budejovice, Ceské Budejovice, Czech Republic.
20
Division of Gastroenterology, Tartu University Hospital,Tartu, Estonia.
21
Department of Medicine, Hospital de Vale de Sousa, Porto, Portugal.
22
Department of Gastroenterology, Hospital de São João, Porto, Portugal.
23
Institute of Pharmacology and Therapeutics, Oporto Medical School, Porto, Portugal.
24
Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal.
25
Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
26
Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova.
27
Private practice, Nicosia, Cyprus.
28
Medical Department, Dronning Ingrids Hospital, Nuuk, Greenland.
29
Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
30
Laboratory Center, Hospital of Southern Jutland, Aabenraa, Denmark.
31
Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
32
Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
33
Department of Medicine, Herning Central Hospital, Herning, Denmark.
34
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
35
Dipartimento Medicina Specialistica Gastroenterologia ed Endoscopia Digestiva, Ospedale Morgagni - Pierantoni, Forlì, Italy.
36
Gastroenterology Unit, Careggi Hospital, Florence, Italy.
37
Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia.
38
Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.
39
St Mark's Hospital, Imperial College London, London, UK.
40
Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.
41
Department of Pediatrics, Hvidovre University Hospital,Hvidovre, Denmark.
42
Department of Gastroenterology, Herlev Univerisity Hospital, Herlev, Denmark.
43
Center for Quality, Region of Southern Denmark, Denmark.
44
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Abstract

Background and aims:

Anaemia is an important complication of inflammatory bowel disease [IBD]. The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis, in a European prospective population-based inception cohort.

Methods:

Newly diagnosed IBD patients were included and followed prospectively for 1 year in 29 European and one Australian centre. Clinical data including demographics, medical therapy, surgery and blood samples were collected. Anaemia was defined according to the World Health Organization criteria.

Results:

A total of 1871 patients (Crohn's disease [CD]: 686, 88%; ulcerative colitis [UC]: 1,021, 87%; IBD unclassified [IBDU] 164. 81%) were included in the study. The prevalence of anaemia was higher in CD than in UC patients and, overall, 49% of CD and 39% of UC patients experienced at least one instance of anaemia during the first 12 months after diagnosis. UC patients with more extensive disease and those from Eastern European countries, and CD patients with penetrating disease or colonic disease location, had higher risks of anaemia. CD and UC patients in need of none or only mild anti-inflammatory treatment had a lower risk of anaemia. In a significant proportion of patients, anaemia was not assessed until several months after diagnosis, and in almost half of all cases of anaemia a thorough work-up was not performed.

Conclusions:

Overall, 42% of patients had at least one instance of anaemia during the first year following diagnosis. Most patients were assessed for anaemia regularly; however, a full anaemia work-up was frequently neglected in this community setting.

KEYWORDS:

anaemia; inflammatory bowel disease; prevalence

PMID:
28575481
DOI:
10.1093/ecco-jcc/jjx077
[Indexed for MEDLINE]

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