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• W2335374080 abstract "Inflammatory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly checked in IBD patients who present with symptoms of active disease. These markers have been shown to correlate with disease activity. Inflammatory markers can be costly and are affected by other factors including age, anemia, temperature and time to processing. Thrombocytosis has also been shown to positively correlate with disease activity. In an effort to reduce the financial burden associated with the delivery of healthcare, we evaluated whether measuring thrombocytes is an effective alternative to monitoring inflammatory markers in IBD patients with active disease. Medical records of 321 patients with ulcerative colitis (UC) and Crohn’s disease at an urban academic inflammatory bowel disease center during an eighteen-month period were evaluated. All encounter-types in which either platelets, ESR, or CRP were available within one week of the visit were examined. Patient age, disease type, symptom activity, ESR and CRP were obtained. A database was created using Microsoft Excel. Statistical analysis was performed using Fisher’s Exact test with significant set at P <0.05. The study was approved by the institutional review board. In 165 encounters of patients with symptoms of active disease, platelets were obtained in 144 encounters, ESR in 57 encounters and CRP in 59 encounters. In 343 encounters of patients without symptoms consistent with active disease, platelets were obtained in 299 encounters, ESR in 79 encounters and CRP in 78 encounters. Thrombocytosis (P = 0.0047), elevated ESR (P = 0.0051) and elevated CRP (P = 0.0039) were all found to be significantly associated with active disease symptoms. In 52 encounters with symptomatic patients, ESR and platelet counts were obtained concurrently. Among encounters associated with elevated ESR, 36% had thrombocytosis while 64% had normal platelet counts. There was no significant difference in these groups (P = 0.12). In 50 encounters with symptomatic patients, CRP and platelet counts were obtained concurrently. Thirty-one percent of encounters associated with elevated CRP values had thrombocytosis, while 69% had normal platelets. There was no significant difference in these groups (P = 0.32). With the rising cost of healthcare and initiatives such as the Affordable Health Care Act, there is increasing pressure to deliver quality, cost-effective care to patients. Thus, it is important that testing not only enhance the quality of medical care, but be financially appropriate. Similar to previous reports, thrombocytosis, elevated ESR, and elevated CRP were all significantly associated with symptoms of active disease in IBD patients. In this study, thrombocytosis did not significantly correlate with elevated inflammatory markers. While not statistically significant, the inflammatory markers were more commonly elevated in symptomatic patients compared to the presence of thrombocytosis. These outcomes may be due to the low total number of patient encounters in which both tests were obtained. Despite additional costs, judicious use of ESR and CRP is appropriate in the evaluation of patients whose symptoms are suggestive of active disease. Further studies are needed to examine the cost-effectiveness of these tests." @default.
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• W2335374080 date "2013-12-01" @default.
• W2335374080 modified "2023-10-17" @default.
• W2335374080 title "P-055 Evaluating Whether Platelet Counts Are a Low Cost Alternative to ESR and CRP in the Evaluation of IBD Patients" @default.
• W2335374080 doi "https://doi.org/10.1097/01.mib.0000438734.98414.6f" @default.
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