Crohn's disease: increased mortality 10 years after diagnosis in a Europe-wide population based cohort
- 1 April 2006
- Vol. 55 (4), 510-518
- https://doi.org/10.1136/gut.2005.072793
Abstract
Background: No previous correlation between phenotype at diagnosis of Crohn’s disease (CD) and mortality has been performed. We assessed the predictive value of phenotype at diagnosis on overall and disease related mortality in a European cohort of CD patients. Methods: Overall and disease related mortality were recorded 10 years after diagnosis in a prospectively assembled, uniformly diagnosed European population based inception cohort of 380 CD patients diagnosed between 1991 and 1993. Standardised mortality ratios (SMRs) were calculated for geographic and phenotypic subgroups at diagnosis. Results: Thirty seven deaths were observed in the entire cohort whereas 21.5 deaths were expected (SMR 1.85 (95% CI 1.30–2.55)). Mortality risk was significantly increased in both females (SMR 1.93 (95% CI 1.10–3.14)) and males (SMR 1.79 (95% CI 1.11–2.73)). Patients from northern European centres had a significant overall increased mortality risk (SMR 2.04 (95% CI 1.32–3.01)) whereas a tendency towards increased overall mortality risk was also observed in the south (SMR 1.55 (95% CI 0.80–2.70)). Mortality risk was increased in patients with colonic disease location and with inflammatory disease behaviour at diagnosis. Mortality risk was also increased in the age group above 40 years at diagnosis for both total and CD related causes. Excess mortality was mainly due to gastrointestinal causes that were related to CD. Conclusions: This European multinational population based study revealed an increased overall mortality risk in CD patients 10 years after diagnosis, and age above 40 years at diagnosis was found to be the sole factor associated with increased mortality risk.Keywords
This publication has 28 references indexed in Scilit:
- General and cancer specific mortality of a population based cohort of patients with inflammatory bowel disease: the Florence studyGut, 1998
- Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD).Gut, 1996
- Survival and cause-specific mortality in inflammatory bowel disease: A population-based cohort studyGastroenterology, 1996
- Mortality from Crohn's disease in Leicestershire, 1972-1989: an epidemiological community based study.Gut, 1992
- Geographic variation in the incidence of and mortality from inflammatory bowel diseaseDiseases of the Colon & Rectum, 1986
- Mortality from Crohn's disease and ulcerative colitis in England-Wales and the U.S. from 1950 to 1983Diseases of the Colon & Rectum, 1986
- Crohn's Disease: Treatment and OutcomeScandinavian Journal of Gastroenterology, 1985
- An International Study of Mortality from Inflammatory Bowel DiseaseDigestion, 1982
- Prognosis of Crohn's disease with onset in childhood or adolescenceDigestive Diseases and Sciences, 1979
- Course and prognosis of Crohn's disease.Gut, 1976