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Childhood-onset inflammatory bowel diseases increase mortality risk

16 Feb 2019

Patients with childhood-onset inflammatory bowel disease (IBD) are more likely to die than the general population, a study suggests.

Researchers identified 9,442 children with IBD (mean age at diagnosis, 13.7±3.5 years; 55.3 percent male) who were then matched for age, sex and place of residence to 93,180 general-population references. National death registries were used to obtain mortality data.  

Over 138,690 person-years of follow-up, 294 deaths were reported in the childhood-onset cohort. The resulting rate (2.1 per 1,000 person-years) was higher than that in the matched reference individuals (940 deaths; 0.7 per 1,000 person-years). In absolute terms, this corresponded to one extra death per 694 childhood-onset IBD patients followed for 1 year.

Following the childhood-onset IBD patients through adulthood revealed a significantly higher likelihood of death relative to the matched general population (hazard ratio [HR], 3.2; 95 percent CI, 2.8–3.6). Analysis according to IBD type showed that this risk was highest in those with ulcerative colitis (HR, 4.0; 3.4–4.7; Crohn’s disease: HR, 2.3; 1.8–2.9).

Deaths were chiefly caused by cancer, which also conferred a sixfold higher risk of death (n=133; HR, 6.6; 5.3–8.2). Diseases of the digestive system, however, were the strongest mortality risk factor (n=54; HR, 36.8; 21.3–67.6).

Notably, the excess mortality associated with childhood-onset IBD remained significant even after >5 years of follow-up (HR, 3.3; 2.9–3.8), nor was it attenuated when analysis was restricted to patients who had been diagnosed after the introduction of biologic treatments. 

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Most Read Articles
5 days ago

Dr Michael Lim, a senior consultant at the Paediatric Pulmonary and Sleep Division, National University Hospital, Singapore, speaks to Roshini Claire Anthony on the rare disease that is cystic fibrosis.

3 days ago
Susceptibility‐guided therapy is as effective as empiric modified bismuth quadruple therapy for the first-line treatment of Helicobacter pylori infection, with both yielding excellent eradication rates, as shown in a recent trial.
5 days ago
It appears that long-term consumption of fish and omega-3 fatty acid does not influence the risk of incident hypertension in middle-aged and older men, suggests a US study.
3 days ago
The risk factors and outcomes associated with an increased risk of permanent pacing include atrial fibrillation (AF) ablation, multivalve surgery and New York Heart Association (NYHA) functional class III/IV, a recent study has found.