Related Experiment Videos
Crohn's disease-specific mortality: a 30-year cohort study at a tertiary referral center in Japan
Shigeyoshi Yasukawa1, Toshiyuki Matsui2, Yutaka Yano1
1Department of Gastroenterology, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-0067, Japan.
Insights
Patients with Crohn's disease (CD) face significantly higher mortality rates from all causes and CD-specific conditions, including cancers and intestinal failure. This highlights the need for improved management and monitoring in CD patient care.
Area of Science:
- Gastroenterology and Hepatology
- Clinical Epidemiology
- Public Health
Background:
- Crohn's disease (CD) is a chronic inflammatory condition with significant implications for patient survival.
- Understanding long-term mortality patterns and causes of death in CD is crucial for clinical management.
Purpose of the Study:
- To investigate survival rates and causes of death in a cohort of patients with Crohn's disease.
- To compare mortality in CD patients with the general population using standardized mortality ratios (SMRs).
Main Methods:
- Retrospective analysis of medical records for 1108 CD patients.
- Life table method used to calculate cumulative survival rates from diagnosis.
- Follow-up surveys conducted for inadequately followed patients; comparison with a sex- and age-matched population model from 2000.
Main Results:
- Cumulative survival at 25 years post-diagnosis was lower in CD patients (91.7%) compared to the standard population (95.7%).
- High SMRs were observed for all causes (3.5) and CD-specific causes (36.7).
- Elevated SMRs for CD-specific causes included intestinal cancers, gastrointestinal diseases (e.g., intestinal failure), perioperative complications, and amyloidosis.
Conclusions:
- Crohn's disease patients exhibit significantly increased mortality from both general and disease-specific causes.
- Intestinal cancer, intestinal failure, perioperative complications, and amyloidosis are key contributors to excess mortality in CD.
Background:
In this study, survival and cause of death were investigated in patients with Crohn's disease (CD) at a tertiary referral center.
Methods:
A database was created based on the medical records of 1108 CD patients who had a history of visiting our hospital to investigate background characteristics, cumulative survival rates from diagnosis, causes of death, and the standardized mortality ratio (SMR) for each cause of death. A follow-up questionnaire survey of patients followed up inadequately was also conducted. The cumulative survival rate from diagnosis was determined using the life table method and compared with that of a sex- and age-matched population model from the year 2000.
Results:
The study included 1108 patients whose mean age at diagnosis was 25.6 ± 10.8 years. The mean duration of follow-up was 14.6 ± 9.4 years, and there were 52 deaths. The cumulative survival rate was significantly lower 25 years after the diagnosis of CD (91.7%) than in the standard population model (95.7%). SMRs for both all causes [3.5; 95% confidence interval (CI): 2.7-4.6] and CD-specific causes (36.7; 95% CI 26.1-51.6) were high. Among the CD-specific causes, SMRs were especially high for small intestine and colorectal cancers, gastrointestinal diseases including intestinal failure (IF), perioperative complications, and amyloidosis.
Conclusion:
The SMRs for both all causes and CD-specific causes were high in CD patients. CD-specific causes including intestinal cancer, IF, perioperative complications, and amyloidosis showed especially high SMRs.