Survival and cause-specific mortality in inflammatory bowel disease: a population-based cohort study

A population-based cohort study of 1251 subjects with Crohn's disease and 1547 subjects with ulcerative colitis, diagnosed in Stockholm between 1955 and 1984, was performed to examine the survival, changes in survival over time, and cause-specific mortality.

The cohort of patients was followed up in the National Cause-of-Death register until 1990. National mortality rates were used for comparisons.

The observed vs. expected survival rate after 15 years was 93.7% (95% confidence interval [CI], 91.8%-95.7%) for Crohn's disease and 94.2% (95% CI, 92.4%-96.1%) for ulcerative colitis. Overall, 174 deaths occurred vs 115.42 expected (standardized mortality ratio, 1.51; 95% CI, 1.29-1.75) in Crohn's disease. In ulcerative colitis, 255 deaths occurred compared with 186.78 expected (standardized mortality ration, 1.37; 95% CI, 1.20-1.54). Inflammatory bowel disease was the major contributor to the elevated mortality rate, but mortality from colorectal cancer, asthma, and non-alcohol-related liver diseases was increased in ulcerative colitis; mortality from other gastrointestinal diseases was increased in ulcerative colitis as well as in Crohn's disease.

Data in the present study are compatible with the hypothesis that subjects with inflammatory bowel disease have an increased mortality compared with the general population.