Mortality and causes of death in patients with inflammatory bowel disease: A nationwide register study in Finland |
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| Institution: | 1. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland;2. Seinäjoki Central Hospital, Seinäjoki, Finland;3. Social Insurance Institution, Research Department, Turku, Finland;4. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland;5. School of Health Sciences, University of Tampere, Tampere, Finland;6. University of Helsinki, Helsinki, Finland;7. Department of Medicine, Institute of Clinical Medicine, Helsinki University Central Hospital, Helsinki, Finland;1. Crohn-Colitis Care Unit, Hospital Universitario Vall d''Hebron, Ciberehd, Paseo Vall d''Hebron 119, 08035, Barcelona, Spain;2. Gastroenterology Department, Hospital Universitario Son Espases, Carretera de Valldemossa, 79, 07120 Palma de Mallorca, Islas Baleares, Spain;3. Gastroenterology Department, Hospital Universitario Central de Asturias, C/Celestino Villamil, s/n, 33006 Oviedo, Asturias, Spain;4. Advanced Research Techniques in Health Services (TAISS), C/Cambrils 49, 28034 Madrid, Spain;1. Department of Biomolecular Chemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland;2. Department of Digestive Tract Diseases, Faculty of Medicine, Medical University of Lodz, Lodz, Poland;3. Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland;4. Department of Psychological and Brain Sciences, Gill Center for Biomolecular Science, Indiana University, Bloomington, IN, USA;5. Department of Pathology, Faculty of Medicine, Medical University of Lodz, Lodz, Poland;6. Department of Medicine, Division of Gastroenterology, Ludwig Maximilians University of Munich, Munich, Germany;1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States;2. Department of Medicine, Mayo Clinic, Rochester, MN, United States;3. Division of Colorectal Surgery, Mayo Clinic, Rochester, MN, United States;4. College of Health Solutions, Arizona State University, Phoenix, AZ, United States;1. Division of Gastroenterology, University of California San Diego, La Jolla, CA, USA;2. Digestive Disease Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;3. Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium;4. Hospital Clinic University of Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain;5. Departments of Radiology and Medicine, University of Calgary, Calgary, AB, Canada;6. Global Medical Affairs Gastroenterology, AbbVie, Rungis, France;7. Department of Medicine, University of Calgary, Calgary, AB, Canada;1. Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy;2. Clinical Sciences, Global Biomarker, Global Discovery, Bayer Healthcare, Bayer, 10178 Berlin, Germany;3. Medicinal Chemistry, Global Drug Discovery, Bayer Healthcare, Bayer, 10178 Berlin, Germany;4. Division of Gastroenterology 2, Careggi Hospital, 50134 Florence, Italy;5. Regional Referral Center for IBD, Careggi Hospital, 50134 Florence, Italy |
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| Abstract: | Background and aimIncreased mortality has been reported in Crohn's disease (CD) but mostly not in ulcerative colitis (UC). We evaluated the overall and cause-specific mortality in a nationwide cohort of patients with inflammatory bowel disease (IBD) in Finland.MethodsA total of 21,964 patients with IBD (16,649 with UC and 5315 with CD) from the Special Reimbursement register were diagnosed 1987–1993 and 2000–2007 and followed up to the end of 2010 by collating these figures with the national computerized Cause-of-Death Register of Statistics Finland. In each cause-of-death category, the number of deaths reported was compared to that expected in general population, and expressed as a standardized mortality ratio (SMR).ResultsOverall mortality was increased among patients with CD (SMR 1.33, 95% confidence interval 1.21–1.46) and UC (1.10, 1.05–1.15). SMR was significantly increased for gastrointestinal causes in CD (6.53, 4.91–8.52) and UC (2.81, 2.32–3.34). Patients with UC were found also to have increased SMR from pulmonary (1.24, 1.02–1.46) and cardiovascular disease (1.14, 1.06–1.22) and cancers of the colon (1.90, 1.38–2.55), rectum (1.79, 1.14–2.69) and biliary tract (5.65, 3.54–8.54), whereas SMR from alcohol-related deaths was decreased (0.54, 0.39–0.71). Patients with CD had a significantly increased SMR for pulmonary diseases (2.01, 1.39–2.80), infections (4.27, 2.13–7.63) and cancers of the biliary tract (4.51, 1.23–11.5) and lymphoid and hematopoietic tissue (2.95, 1.85–4.45).ConclusionsIn this Finnish nationwide study increased overall mortality in both CD and UC was observed. The excess mortality of 14 % in IBD is mainly due to deaths related to inflammation in the gut. |
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