title: Hemoglobin and hematocrit levels in the prediction of complicated Crohn's disease behavior--a cohort study.
abstract: BACKGROUND
  Markers that predict the occurrence of a complicated disease behavior in patients with Crohn's disease (CD) can permit a more aggressive therapeutic regimen for patients at risk. The aim of this cohort study was to test the blood levels of hemoglobin (Hgb) and hematocrit (Hct) for the prediction of complicated CD behavior and CD related surgery in an adult patient population.
  
  
  METHODS
  Blood samples of 62 CD patients of the German Inflammatory Bowel Disease-network "Kompetenznetz CED" were tested for the levels of Hgb and Hct prior to the occurrence of complicated disease behavior or CD related surgery. The relation of these markers and clinical events was studied using Kaplan-Meier survival analysis and adjusted COX-proportional hazard regression models.
  
  
  RESULTS
  The median follow-up time was 55.8 months. Of the 62 CD patients without any previous complication or surgery 34% developed a complication and/or underwent CD related surgery. Low Hgb or Hct levels were independent predictors of a shorter time to occurrence of the first complication or CD related surgery. This was true for early as well as late occurring complications. Stable low Hgb or Hct during serial follow-up measurements had a higher frequency of complications compared to patients with a stable normal Hgb or Hct, respectively.
  
  
  CONCLUSIONS
  Determination of Hgb or Hct in complication and surgery naïve CD patients might serve as an additional tool for the prediction of complicated disease behavior.
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany; Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America; Department of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio, United States of America.
authors.forename: Florian
authors.initials: F
authors.lastname: Rieder
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Gisela
authors.initials: G
authors.lastname: Paul
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schnoy
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Schleder
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Wolf
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Kamm
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dirmeier
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Strauch
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Obermeier
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America.
authors.forename: Rocio
authors.initials: R
authors.lastname: Lopez
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America; Department of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio, United States of America.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Achkar
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital, Zurich, Switzerland.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Rogler
authors.affiliation: Department of Internal Medicine I, University of Regensburg, Regensburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Klebl
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D004912:Erythrocytes; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins