Mortality and causes of death in Crohn's disease: results from 20 years of follow-up in the IBSEN study
Mortality and causes of death in Crohn's disease: results from 20 years of follow-up in the IBSEN study
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DOI：
10.1136/gutjnl-2013-304766
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发表时间：
2014-05-01
期刊：
影响因子：
24.5
通讯作者：
Moum, Bjorn A.
中科院分区：
文献类型：
--
作者：
Hovde, Oistein;Kempski-Monstad, Iril;Moum, Bjorn A.
目的以人群为基础的研究表明克罗恩病(CD)患者的预期寿命略有下降。本研究的主要目的是评估挪威CD患者确诊20年后的死亡率和死亡原因。设计：挪威东南部炎症性肠病研究前瞻性地跟踪了1990年1月1日至1993年12月31日期间在四个地理定义明确的地区所有被诊断为CD的患者。所有患者(n=237)的年龄和性别与从普通人群中随机抽取的同一县的25人相匹配。关于死亡和死因的数据是从挪威死因登记册收集的。所有的原因和特定原因的死亡率(胃肠癌、癌症和心脏病)用COX回归模型按配对集合分层建模，结果以95%的CI表示为HRs。结果CD组总病死率与对照组比较差异无统计学意义(HR=1.35，95%CI 0.94~1.94，P=0.10)。此外，与对照组相比，CD组死于胃肠道癌症、其他癌症或心血管疾病的人数没有显著差异。CD组的死亡率为13.9%，而对照组为12.7%(p=0.578)。结论在我们以人群为基础的初始队列中，与普通人群相比，没有增加死亡率或更多的癌症死亡。
Objective Population-based studies have shown a slightly decreased life expectancy in patients with Crohn's disease (CD). The primary aim of the present study was to evaluate mortality and causes of death 20 years after the diagnosis in a well defined population-based cohort of CD patients in Norway.Design The Inflammatory Bowel South-Eastern Norway study has prospectively followed all patients diagnosed with CD in the period between 1 January 1990 and 31 December 1993 in four geographically well-defined areas. All patients (n=237) were age and sex matched with 25 persons from the same county selected at random from the general population. Data on death and causes of deaths were collected from the Norwegian Causes of Death Register. All causes and cause-specific mortality (gastrointestinal cancer, cancer and heart disease) were modelled with Cox regression model stratified by matched sets.Results are expressed as HRs with 95% CIs. Results There was no significant difference between CD patients and controls in overall mortality (HR=1.35, 95% CI 0.94 to 1.94, p=0.10). Furthermore, there were no marked differences in deaths from gastrointestinal cancer, other cancers or cardiovascular diseases in the CD group compared with the controls. In the CD group, 13.9% had died compared with 12.7% in the control group (p=0.578).Conclusions In our population-based inception cohort followed for 20 years, there was no increased mortality or more deaths from cancer compared with the general population.