Ulcerative colitis: no rise in mortality in a European-wide population based cohort 10 years after diagnosis

TY - JOUR

T1 - Ulcerative colitis

T2 - no rise in mortality in a European-wide population based cohort 10 years after diagnosis

AU - Höie, O

AU - Schouten, L J

AU - Wolters, F L

AU - Solberg, I C

AU - Riis, L

AU - Mouzas, I A

AU - Politi, P

AU - Odes, S

AU - Langholz, E

AU - Vatn, M

AU - Stockbrügger, R W

AU - Moum, B

AU - European Collaborative Study Group of Inflammatory Bowel Disease (EC-IBD)

PY - 2007/4

Y1 - 2007/4

N2 - BACKGROUND: Population based studies have revealed varying mortality for patients with ulcerative colitis but most have described patients from limited geographical areas who were diagnosed before 1990.AIMS: To assess overall mortality in a European cohort of patients with ulcerative colitis, 10 years after diagnosis, and to investigate national ulcerative colitis related mortality across Europe.METHODS: Mortality 10 years after diagnosis was recorded in a prospective European-wide population based cohort of patients with ulcerative colitis diagnosed in 1991-1993 from nine centres in seven European countries. Expected mortality was calculated from the sex, age and country specific mortality in the WHO Mortality Database for 1995-1998. Standardised mortality ratios (SMR) and 95% confidence intervals (CI) were calculated.RESULTS: At follow-up, 661 of 775 patients were alive with a median follow-up duration of 123 months (107-144). A total of 73 deaths (median follow-up time 61 months (1-133)) occurred compared with an expected 67. The overall mortality risk was no higher: SMR 1.09 (95% CI 0.86 to 1.37). Mortality by sex was SMR 0.92 (95% CI 0.65 to 1.26) for males and SMR 1.39 (95% CI 0.97 to 1.93) for females. There was a slightly higher risk in older age groups. For disease specific mortality, a higher SMR was found only for pulmonary disease. Mortality by European region was SMR 1.19 (95% CI 0.91 to 1.53) for the north and SMR 0.82 (95% CI 0.45-1.37) for the south.CONCLUSIONS: Higher mortality was not found in patients with ulcerative colitis 10 years after disease onset. However, a significant rise in SMR for pulmonary disease, and a trend towards an age related rise in SMR, was observed.

AB - BACKGROUND: Population based studies have revealed varying mortality for patients with ulcerative colitis but most have described patients from limited geographical areas who were diagnosed before 1990.AIMS: To assess overall mortality in a European cohort of patients with ulcerative colitis, 10 years after diagnosis, and to investigate national ulcerative colitis related mortality across Europe.METHODS: Mortality 10 years after diagnosis was recorded in a prospective European-wide population based cohort of patients with ulcerative colitis diagnosed in 1991-1993 from nine centres in seven European countries. Expected mortality was calculated from the sex, age and country specific mortality in the WHO Mortality Database for 1995-1998. Standardised mortality ratios (SMR) and 95% confidence intervals (CI) were calculated.RESULTS: At follow-up, 661 of 775 patients were alive with a median follow-up duration of 123 months (107-144). A total of 73 deaths (median follow-up time 61 months (1-133)) occurred compared with an expected 67. The overall mortality risk was no higher: SMR 1.09 (95% CI 0.86 to 1.37). Mortality by sex was SMR 0.92 (95% CI 0.65 to 1.26) for males and SMR 1.39 (95% CI 0.97 to 1.93) for females. There was a slightly higher risk in older age groups. For disease specific mortality, a higher SMR was found only for pulmonary disease. Mortality by European region was SMR 1.19 (95% CI 0.91 to 1.53) for the north and SMR 0.82 (95% CI 0.45-1.37) for the south.CONCLUSIONS: Higher mortality was not found in patients with ulcerative colitis 10 years after disease onset. However, a significant rise in SMR for pulmonary disease, and a trend towards an age related rise in SMR, was observed.

KW - Adolescent

KW - Adult

KW - Age Distribution

KW - Aged

KW - Aged, 80 and over

KW - Cardiovascular Diseases/mortality

KW - Child

KW - Colitis, Ulcerative/drug therapy

KW - Drug Administration Schedule

KW - Epidemiologic Methods

KW - Europe/epidemiology

KW - Female

KW - Gastrointestinal Agents/administration & dosage

KW - Gastrointestinal Diseases/mortality

KW - Humans

KW - Israel/epidemiology

KW - Lung Diseases/mortality

KW - Male

KW - Middle Aged

KW - Neoplasms/mortality

KW - Sex Distribution

U2 - 10.1136/gut.2006.101519

DO - 10.1136/gut.2006.101519

M3 - Journal article

C2 - 17028127

SN - 0017-5749

VL - 56

SP - 497

EP - 503

JO - Gut

JF - Gut

IS - 4

ER -