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老年人患上IBD的流行病学:全国人口基的队列研究
Siddharth Singh1, Gry Juul Poulsen2, Tania Hviid Bisgaard2
1Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, California.
概括
在70岁以上被诊断的非常晚发炎性肠病 (IBD) 的发病率与晚发IBD的发病率相似,但感染和心血管事件的风险更高. 在非常老年IBD人群中,治疗和手术率较低.
科学领域:
- 胃肠病学 胃肠病学
- 流行病学 流行病学
- 老年医学 老年医学
背景情况:
- 炎症性肠病 (IBD),包括克罗恩病 (CD) 和性结肠炎 (UC),在老年人中越来越多地被诊断为炎症性肠病.
- 与晚发IBD (60-69岁) 相比,了解晚发IBD (≥70岁) 的不同特征和结果对于优化患者护理至关重要.
研究的目的:
- 调查非常晚发性IBD的发病率和自然史.
- 为了比较非常晚发性IBD和晚发性IBD患者之间的治疗模式,住院风险和不良事件.
主要方法:
- 一项使用丹麦国家患者登记册 (1980-2018) 的全国性队列研究.
- 包括60岁以上的新诊断的CD或UC的个人.
- 使用非参数竞争性风险分析,将死亡作为竞争性风险,以评估结果.
主要成果:
- 确定了3459名60岁以上的CD和10774名UC患者,分别有47%和51%的患者在70岁以上被诊断出来.
- 在过去的三十年中,非常晚发 IBD 和晚发 IBD 的发病率趋势相似.
- 虽然住院治疗和使用皮质类固醇是可比的,但非常晚发的IBD患者的疾病修饰疗法和手术率较低,但严重感染和心血管事件的风险更高.
结论:
- 晚期发病的IBD患者面临着更大的疾病和衰老相关并发症负担.
- 在这个老年人群中,仅限于使用类固醇节约疗法和外科手术.
- 这些发现凸显了针对老年IBD患者量身定制的治疗策略的必要性.
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