Persistent or Recurrent Anemia Is Associated With Severe and Disabling Inflammatory Bowel Disease

Koutroubakis, Ioannis E.; Ramos-Rivers, Claudia; Regueiro, Miguel; Koutroumpakis, Efstratios; Click, Benjamin; Schoen, Robert E.; Hashash, Jana G.; Schwartz, Marc; Swoger, Jason M.; Baidoo, Leonard; Barrie, Arthur; Dunn, Michael A.; Binion, David G.

doi:10.1016/j.cgh.2015.03.029

Cited by 61 publications

(54 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We identified several risk factors that were independently associated with significantly increased odds of hospitalization following an IBD-related ED visit. The presence of anemia in IBD patients has been found to be associated with more severe disease, disease-related complications or surgeries, lower quality of life, and higher healthcare utilization [11,29,30]. Similarly, in our study 20 % of IBD patients had anemia with *8 times greater odds of hospitalization.…”

Section: Discussionsupporting

confidence: 73%

Analysis of Hospital-Based Emergency Department Visits for Inflammatory Bowel Disease in the USA

et al. 2015

Self Cite

View full text Add to dashboard Cite

The IBD-related ED visits have remained relatively stable from 2009 to 2011. The presence of anemia, malnutrition, hypovolemia, electrolyte abnormalities, fever, abnormal white cell count, bowel obstruction, or intra-abdominal abscess during the ED visit was associated with hospitalization. The presence of bowel obstruction and intra-abdominal abscess was strongly associated with surgical intervention.

show abstract

Section: Discussionsupporting

confidence: 73%

Analysis of Hospital-Based Emergency Department Visits for Inflammatory Bowel Disease in the USA

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…23 Two recent studies found that anemia was associated with a more severe disease course and could be used as an objective marker of disabling disease in IBD. 12,24 Among chronic diseases with variable courses between individuals including IBD, hospitalization related to the disease appears to be a clear marker for increased disease activity and marked aggressiveness of disease course in the future. In UC, medical hospitalization has been reported to predict future colectomy.…”

Section: Discussionmentioning

confidence: 99%

“…External validation from other populations is needed in future studies, although multiple studies from Binion and colleagues at the University of Pittsburgh have already found several of these bivariate predictors to be valid in their tertiary care patient population. 12,18 …”

Section: Discussionmentioning

confidence: 99%

“…These include disease factors such as extensive disease, fistulizing disease, high inflammatory activity, early need for corticosteroids, need for biologic therapy, and patient factors such as young age, prior smoking, anemia, and high numbers of telephone encounters, which have been reported as predictors of hospitalizations or surgeries. 7–12 These factors may be used by physicians to identify patients who could benefit from earlier and more aggressive treatment. The increasing use of electronic medical records (EMRs) allows for new opportunities to flag these patients in an automated fashion.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Factors That Predict High Health Care Utilization and Costs for Patients With Inflammatory Bowel Diseases

Limsrivilai

Stidham

Govani

et al. 2017

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

BACKGROUND & AIMS A subset of patients with inflammatory bowel diseases (IBD) have continuously active inflammation, leading to a high number of complications and high direct health care costs (diagnostic tests, medications, and surgeries) and indirect costs (reduced employment and productivity and fewer opportunities for activities). Identifying these high-risk patients and providing effective interventions could produce better outcomes and reduce costs. We used prior year data to create IBD risk models to predict IBD-related hospitalizations, emergency department visits, and high treatment charges (>$30,000/year) in the subsequent year. METHODS We performed a retrospective study of medical records from all patients with IBD treated at the University of Michigan Hospital from fiscal years 2013–2015. We selected clinical variables from the prior year and tested their abilities to predict 3 adverse outcomes (IBD-related hospitalizations, emergency department visits, and treatment charges >$30,000/year) in the subsequent year. Individual patients were only included once in the data set. We created a multivariate model that was based on a 70% randomly selected cohort (1005 patients) and validated the model on the other 30% (425 patients). Logistic regression was used for bivariate and multivariate analyses. RESULTS Factors that predicted high-cost outcomes included the presence of psychiatric illness, use of corticosteroids, use of narcotics, low levels of hemoglobin, and high numbers of IBD-related hospitalizations. In the validation cohort, the model predicted IBD-related hospitalizations, emergency department visits, and high charges in the following year with receiver operating characteristic curve values of 0.751, 0.738, and 0.744, respectively. CONCLUSIONS We identified 5 factors that can effectively identify patients with IBD at high risk for hospitalization, emergency department visits, and high treatment charges in the next year. These patients should be closely monitored and aggressively managed.

show abstract

“…One of these complications is a deficiency in iron, causing low levels of hemoglobin and leading to anemia 142 . Anemia is common in IBD and is linked to poor prognosis 143 . The causes of anemia in IBD could be linked to intestinal bleeding or malabsorption, which turns IBD into a debilitating disorder 142 .…”

Section: Hydroxylase Inhibitors: a New Therapeutic Approach In Ibdmentioning

confidence: 99%

Hypoxia Inducible Factor (HIF) Hydroxylases as Regulators of Intestinal Epithelial Barrier Function

Manresa¹,

Taylor

2017

Cellular and Molecular Gastroenterology and Hepatology

View full text Add to dashboard Cite

Human health is dependent on the ability of the body to extract nutrients, fluids, and oxygen from the external environment while at the same time maintaining a state of internal sterility. Therefore, the cell layers that cover the surface areas of the body such as the lung, skin, and gastrointestinal mucosa provide vital semipermeable barriers that allow the transport of essential nutrients, fluid, and waste products, while at the same time keeping the internal compartments free of microbial organisms. These epithelial surfaces are highly specialized and differ in their anatomic structure depending on their location to provide appropriate and effective site-specific barrier function. Given this important role, it is not surprising that significant disease often is associated with alterations in epithelial barrier function. Examples of such diseases include inflammatory bowel disease, chronic obstructive pulmonary disease, and atopic dermatitis. These chronic inflammatory disorders often are characterized by diminished tissue oxygen levels (hypoxia). Hypoxia triggers an adaptive transcriptional response governed by hypoxia-inducible factors (HIFs), which are repressed by a family of oxygen-sensing HIF hydroxylases. Here, we review recent evidence suggesting that pharmacologic hydroxylase inhibition may be of therapeutic benefit in inflammatory bowel disease through the promotion of intestinal epithelial barrier function through both HIF-dependent and HIF-independent mechanisms.

show abstract

Persistent or Recurrent Anemia Is Associated With Severe and Disabling Inflammatory Bowel Disease

Cited by 61 publications

References 27 publications

Analysis of Hospital-Based Emergency Department Visits for Inflammatory Bowel Disease in the USA

Analysis of Hospital-Based Emergency Department Visits for Inflammatory Bowel Disease in the USA

Factors That Predict High Health Care Utilization and Costs for Patients With Inflammatory Bowel Diseases

Hypoxia Inducible Factor (HIF) Hydroxylases as Regulators of Intestinal Epithelial Barrier Function

Contact Info

Product

Resources

About