Abstract Number: PB0929
Meeting: ISTH 2021 Congress
Background: Von Willebrand disease (VWD) is estimated to affect 1% of the general population. The morbidity associated with bleeding in females with VWD is high and associated with iron deficiency (IDA). However, the prevalence and factors associated with IDA in females with VWD have not been clearly identified.
Aims: To assess prevalence of and factors associated with IDA in VWD in a national discharge database.
Methods: Retrospective analysis of discharge data from the National Inpatient Sample (NIS) between 2005 and 2014 was performed. Adult females with and without VWD, with or without IDA, were identified by International Disease Classification (ICD) codes. Prevalence estimates were weighted using NIS-provided discharge-level weights to reflect national estimates. Categorical variables were analyzed by Rao-Scott chi square test, and continuous variables by weighted simple linear regression. Covariates associated with IDA were identified by weighted multivariable logistic regression.
Results: A total of 19,774 female admissions with diagnosis of VWD were identified, among whom IDA prevalence was 6.3 %. VWD discharges with IDA were more likely to have upper GI bleeding (GIB) (14.9% vs. 2.6%), lower GIB (8.1% vs. 1.3%), chronic kidney disease (7.3% vs. 3.7%), thrombocytopenia (5.7% vs. 2.8%), angiodysplasia with hemorrhage (3.6% vs. 0.3%), and heavy menstrual bleeding (HMB) (3.5% vs. 0.8%) compared to VWD without IDA, all p<0.001. Compared with non-VWD with IDA, VWD with IDA had 3-fold more post-procedure bleeding (p<0.001). Among patients with VWD, the odds of IDA is higher among those with (versus without) lower GIB (OR=6.84 [CI 4.71, 9.93]); with upper GIB (OR=6.01 [CI 4.80, 7.52]); with HMB (OR=5.29 [CI 3.61, 7.75]); with epistaxis (OR=2.41 [CI 1.55, 3.75]); or with postpartum hemorrhage (OR=2.03 [CI 1.19, 3.47]).
Conclusions: GIB and HMB were significantly associated with IDA among women with VWD, but the low IDA prevalence suggests testing is infrequent.
To cite this abstract in AMA style:Amouzegar A, Jeong K, Yabes JG, Ragni MV. Prevalence and Predictors of Iron Deficiency Anemia in Women with von Willebrand Disease: An NIS Study [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/prevalence-and-predictors-of-iron-deficiency-anemia-in-women-with-von-willebrand-disease-an-nis-study/. Accessed September 29, 2023.
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