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Mortality Risk of Inflammatory Bowel Disease: A Case–Control Study of New York State Death Records

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Abstract

Background

Studies examining the mortality risk of inflammatory bowel disease (IBD) have yielded conflicting results, and most do not account for recent advancements made in the treatment of Crohn’s disease (CD) and ulcerative colitis (UC). We aim to assess the overall, premature, and cause-specific mortality in IBD patients over a 17-year time period and to evaluate any differences since the introduction of biologic therapy.

Methods

A death record case–control study was performed to explore the odds of premature death (before age 65) and all-cause mortality among those with IBD. Cases consisted of IBD patients (1,129 with CD and 841 with UC) who died in New York State (NYS) from 1993 to 2010. Controls (n = 7880) were matched 4:1 on the basis of sex and zip code from those who died in NYS in the same time frame, without an IBD diagnosis.

Results

Compared with matched controls, those with CD (OR 1.56, CI 95% 1.34–1.82), but not UC (OR 0.72, CI 95% 0.59–0.89), were more likely to die prematurely. Both those with UC and CD were more likely to die from a gastrointestinal cause (CD OR 15.28, 95% CI 12.11–19.27; UC OR 14.02, 95% CI 10.76–18.26). There was no difference in the cause or age of death before and after the introduction of anti-TNF agents in those with IBD.

Conclusions

Both CD and UC cases were more likely to die of a gastrointestinal etiology, and CD patients were more likely to die prematurely. There was no significant difference in the premature death, average age of death, and cause of death in this IBD population after the availability of anti-TNF therapy.

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Acknowledgment

Technical support: Sarah Monks.

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Author notes

  1. Angelica Nocerino and Alexandra Feathers contributed equally to this work and should be acknowledged as co-first authors.

Authors and Affiliations

  1. Division of Gastroenterology, Lenox Hill Hospital, 100 East 77th St., 2nd Floor, New York, NY, 10075, USA

    Angelica Nocerino, Alexandra Feathers, Elena Ivanina, Laura Durbin & Arun Swaminath

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  1. Angelica Nocerino
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  2. Alexandra Feathers
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  3. Elena Ivanina
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Contributions

Angelica Nocerino contributed to interpretation of data, drafting, and revising the paper. Alexandra Feathers contributed to acquisition and analysis of data, drafting, and revision of the paper. Elena Ivanina contributed to interpretation of data and revision of paper. Laura Durbin contributed to analysis and interpretation of data and revised the paper. Arun Swaminath conceived and designed the project, interpreted data, and revised the paper. All authors have given the final approval of the paper.

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Correspondence to Arun Swaminath.

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AS: Grant funding from: Pfizer, Takeda, Janssen, Abbvie. Advisory board: Pfizer.

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Nocerino, A., Feathers, A., Ivanina, E. et al. Mortality Risk of Inflammatory Bowel Disease: A Case–Control Study of New York State Death Records. Dig Dis Sci 64, 1604–1611 (2019). https://doi.org/10.1007/s10620-018-5430-8

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  • DOI: https://doi.org/10.1007/s10620-018-5430-8

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