The Clinical Characteristics And Quality Of Life In Patients With Inflammatory Bowel Disease-Associated Anemia In Fujian Province

Objective:Anemia is one of the complications in patients with inflammatory bowel disease（IBD）.This study was aimed to explore the IBD-anemia characteristics,and its impact on quality of life（QOL）in IBD patients,and to preliminarily explored the risk factors of IBD-anemia,which may help to guide the management of anemia.Methods:The incidence,clinical characteristics,treatment of IBD-anemia,and the medical utilization were respectively analyzed in inpatients with Crohn’s disease（CD）and ulcerative colitis（UC）at the First Affiliated Hospital of Fujian Medical University from January 2016 to February 2021.The SF-36 and FS-14 questionnaires for patients with IBD were also performed.Results:A total of 697 inpatients with IBD were enrolled,of which 492 CD were patients（M/F=356/136）with median age of 25（19,32）years,and median disease course of12（6,36）months,and 205 were UC（M/F=124/81）with median age of 48（35,57）years,and median disease course of 24（8,84）months.（1）The anemia incidence in IBD patients was 35.6%（248/697）with 71.0%（176/248）of mild anemia,and 44.8%（111/248）of microcytic hypochromic anemia.The anemia incidence in CD patients was 38.2%（188/492）,which was higher than in UC patients（29.3%（60/205））（x²=5.049,P=0.025）.（2）The drug costs,hospitalization costs and length of stay were significantly higher in both CD and UC patients with anemia than those in non-anemia patients（P<0.001）.（3）The multivariate analysis showed that female,disease activity,gastrointestinal hemorrhage,elevated PLT and ESR were the risk factors of anemia in CD patients,and elevated PLT and ESR were in UC,and higher ALB was a protective factor（P<0.05）for both CD and UC.（4）Only 25.8%IBD patients with anemia had received the treatment of anemia.The HGB levels had a significantly elevated at the 14^thweek（P<0.001）and at the 30^thweek（P<0.001）after anemia therapy.So,it is appropriate to evaluate the efficacy of anemia treatment at the 14^thweek.A total of 123 valid SF-36 and FS-14 questionnaires were collected from IBD patients,of which 116 cases were CD patients（94.3%）and 7 were UC（5.7%）.30cases（24.4%）reported anemia.The SF-36 score in anemia patients was 105.5（95.4,121.1）,which was lower than in non-anemia（119.8（101.4,127.8））（z=-2.545,P=0.011）.The FS-14 score in anemia patients（9.0（3.0,11.3））was higher than in non-anemia（6.0（2.0,9.0））（z=-2.221,P=0.026）.HGB level was positively correlated with SF-36 score（Kendall’s tau-b=0.244,P<0.001）and negatively with FS-14 score（Kendall’s tau-b=-0.164,P=0.01）.Conclusion:About 1/3 IBD patients had anemia,and most of them were mild and microcytic hypochromic anemia.Disease activity,elevated PLT and ESR are the risk factors of anemia.Anemia may decrease the patient’s quality of life,and significantly increase the medical costs.However,only about 1/4 anemia patients had received the treatment for anemia.