Mortality After First Hospital Admission for Inflammatory Bowel Disease: A Nationwide Registry Linkage Study
Opstelten, Jorrit L.; Vaartjes, Ilonca; Bots, Michiel L.; Oldenburg, Bas
(2019) Inflammatory bowel diseases, volume 25, issue 10, pp. 1692 - 1699
(Article)
Abstract
BACKGROUND: The goal of this study was to determine long-term mortality and causes of death in patients after hospitalization for inflammatory bowel disease (IBD). METHODS: A cohort of patients admitted to the hospital because of IBD for the first time between 1998 and 2010 was identified by linkage of nationwide
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Dutch registries. Mortality risks and causes of death in Crohn's disease (CD) and ulcerative colitis (UC) patients were compared with a large random sample of individuals from the general population. Multivariable Cox regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: In total, 23,003 patients (56.1% women; mean age, 44.8 years) were hospitalized for IBD. Patients admitted for IBD had a higher risk of death than those from the general population. Adjusted HRs for 5-year all-cause mortality were 2.42 (95% CI, 1.15-5.12) and 1.45 (95% CI, 1.26-1.66) in men and women hospitalized for CD, respectively. Corresponding HRs for UC were 1.59 (95% CI, 1.39-1.83) and 1.13 (95% CI, 0.98-1.31). Mortality among patients after hospitalization for IBD decreased between 1998-2004 and 2005-2010. Patients admitted for UC had a higher risk of all-cause mortality than those admitted for CD. Inflammatory bowel disease patients died more often from (colorectal) cancer and gastrointestinal disease and less often from cardiovascular disease relative to the general population. CONCLUSIONS: Mortality of patients after hospitalization for IBD has decreased over time. Causes of death in CD and UC patients differ from those in the general population.
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Keywords: Crohn’s disease, Epidemiology, Time trend, Ulcerative colitis, Gastroenterology, Immunology and Allergy, Journal Article
ISSN: 1078-0998
Publisher: John Wiley and Sons Inc.
Note: Funding Information: Received for publications December 8, 2018; Editorial Decision February 26, 2019. From the *Department of Gastroenterology and Hepatology and †Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands Conflicts of interest: None declared. aEqual contribution, co-last authors Supported by: This work was in part supported by a grant from the Dutch Heart Foundation (grant DHF project “Facts and Figures”) to Ilonca Vaartjes and an unrestricted research grant from Dr Falk Pharma to Bas Oldenburg. Author contributions: J.L.O. contributed to the acquisition and interpretation of data and drafted the manuscript. I.V. contributed to the acquisition, analysis, and interpretation of the data and critically reviewed the manuscript. M.L.B. and B.O. supervised the study and provided important contributions to all aspects of this work. All authors approved the final draft submitted. Address correspondence to: B. Oldenburg, MD, PhD, Department of Gastroenterology and Hepatology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands (boldenbu@umcutrecht.nl). © 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and repro-duction in any medium, provided the original work is properly cited. For commer-cial re-use, please contact journals.permissions@oup.com doi: 10.1093/ibd/izz055 Published online 27 March 2019 Funding Information: This work was in part supported by a grant from the Dutch Heart Foundation (grant DHF project ?Facts and Figures?) to Ilonca Vaartjes and an unrestricted research grant from Dr Falk Pharma to Bas Oldenburg. Publisher Copyright: © 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.
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