Dr Aoibhlinn O'Toole and colleagues from Ireland assessed mortality in inflammatory bowel disease (IBD) patients under 65 years of age, and identified the factors related to death in this age group.
The research team studied 2570 IBD patients who were diagnosed as having disease before 65 years of age and attended a single tertiary referral center area between 1983 and 2012.
Follow-up was censored at 65 years.
The team determined causes of death from death certificates obtained from the Irish registry office of births, marriages and deaths.
Observed all-cause survival was compared with expected survival of persons of the same age and sex in the general population.
|41 out of 52 deaths were IBD related|
|Scandanavian Journal of Gastroenterology|
Expected survival was obtained from national life tables produced by the central statistics office.
The researchers calculated survival estimates for disease type, disease site, gender, the presence of primary sclerosing cholangitis (PSC), immunomodulator use, biologic therapy use, presence of fistulating disease and prior surgery.
The team identified 52 deaths that were reported in the population younger than 65 years, of which 41 were IBD related.
The researchers found little difference in survival in the first 25 years of follow-up, but relative survival decreased in both the Crohn's disease (CD) and ulcerative colitis (UC) cohort thereafter.
The team observed that 30-year mortality was excessive in both groups.
An adjusted multivariate regression analysis of patients with CD identified primary sclerosing cholangitis as the only predictor of premature mortality.
PSC was also identified as the only independent predictor of mortality in UC patients.
Dr O'Toole's team comments, "The presence of primary sclerosing cholangitis poses the greatest risk for mortality in both UC and CD."