Abomhya Ahmed, Tai Waqqas, Ayaz Salman, Khan Farrah, Saadedeen Waleed, Ajala Olufunmilola, Mohamed Rana
Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA.
Digestive Diseases and Nutrition Department, University of Kentucky, Lexington, KY, USA.
J Hematol. 2022 Apr;11(2):55-61. doi: 10.14740/jh989. Epub 2022 Apr 12.
There are few studies to evaluate the association between iron deficiency anemia (IDA) and Crohn's disease (CD). We examined this association in a USA-based cohort of patients with CD.
We queried the Nationwide Readmission Databases 2018 using the International Classification of Disease, 10th Revision, and Clinical Modification (ICD-10-CM) codes to identify all adult patients admitted with a diagnosis of CD. Primary outcomes were the prevalence of IDA among patients with CD. Secondary outcomes included inpatient mortality, the length of stay, all-cause 30-day non-elective readmission rate, and total cost of hospitalization. Multivariate regression analysis was performed to study the impact of IDA on inpatient mortality and non-elective readmissions.
Of the 72,076 patients discharged from an index hospitalization for CD, 8.1% had IDA. CD patients with IDA had increased length of stays in days (4, interquartile range (IQR): 2 - 6 vs. 3, IQR: 2 - 5; P < 0.001), increased median total charges ($35,160, IQR: $19,786 - $64,126 vs. $31,299, IQR: $17,226 - $59,561; P < 0.001), and were more common to require blood transfusion during hospitalization (13.6% vs. 3.4%, P < 0.001) compared to CD patients without IDA, respectively. IDA was independently associated with increased odds of all-cause 30-day non-elective readmission (odds ratio (OR): 1.254, 95% confidence interval (CI): 1.154 - 1.363, P < 0.001) and increased odds of all-cause 90-day non-elective readmission (OR: 1.396, 95% CI: 1.302 - 1.498, P < 0.001).
In a large nationwide cohort of patients hospitalized for CD, we observed a significant burden of IDA. Additionally, we found a significant association between IDA and worse hospitalization outcomes.
评估缺铁性贫血（IDA）与克罗恩病（CD）之间关联的研究较少。我们在美国的CD患者队列中研究了这种关联。
我们使用国际疾病分类第十版临床修订本（ICD - 10 - CM）编码查询了2018年全国再入院数据库，以识别所有诊断为CD的成年住院患者。主要结局是CD患者中IDA的患病率。次要结局包括住院死亡率、住院时间、全因30天非选择性再入院率以及住院总费用。进行多变量回归分析以研究IDA对住院死亡率和非选择性再入院的影响。
在72,076名因CD首次住院出院的患者中，8.1%患有IDA。与无IDA的CD患者相比，患有IDA的CD患者住院天数增加（中位数4天，四分位间距（IQR）：2 - 6天 vs. 3天，IQR：2 - 5天；P < 0.001），总费用中位数增加（35,160美元，IQR：19,786 - 64,126美元 vs. 31,299美元，IQR：17,226 - 59,561美元；P < 0.001），并且住院期间更常需要输血（13.6% vs. 3.4%，P < 0.001）。IDA与全因30天非选择性再入院几率增加（优势比（OR）：1.254，95%置信区间（CI）：1.154 - 1.363，P < 0.001）以及全因90天非选择性再入院几率增加（OR：1.396，95% CI：1.302 - 1.498，P < 0.001）独立相关。
在一个因CD住院的大型全国性患者队列中，我们观察到IDA负担较重。此外，我们发现IDA与更差的住院结局之间存在显著关联。
