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

  • Angelica Nocerino
  • Alexandra Feathers
  • Elena Ivanina
  • Laura Durbin
  • Arun Swaminath
Original Article

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.

Keywords

Mortality Premature death, inflammatory bowel disease Biological therapy Complications of inflammatory bowel disease 

Notes

Acknowledgment

Technical support: Sarah Monks.

Author's contribution

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.

Compliance with ethical standards

Conflict of interest

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

References

  1. 1.
    Loftus EV Jr. Progress in the diagnosis and treatment of inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2011;7:3–16.Google Scholar
  2. 2.
    Kilcoyne A, Kaplan JL, Gee MS. Inflammatory bowel disease imaging: current practice and future directions. World J Gastroenterol. 2016;22:917–932.CrossRefGoogle Scholar
  3. 3.
    D’Haens G. Risks and benefits of biologic therapy for inflammatory bowel diseases. Gut. 2007;56:725–732.CrossRefGoogle Scholar
  4. 4.
    Lewis JD, Scott FI, Brensinger CM, et al. Reduced mortality rates with anti-tumor necrosis factor alpha directed therapy when compared to prolonged corticosteroid therapy for inflammatory bowel disease. Gastroenterology. 2017;152:S64–S65.CrossRefGoogle Scholar
  5. 5.
    Sewell JL, Yee HF Jr. 13-year mortality trends among hospitalized patients with inflammatory bowel disease. BMC Gastroenterol. 2012;12:79.CrossRefGoogle Scholar
  6. 6.
    Romberg-Camps M, Kuiper E, Schouten L, et al. Mortality in inflammatory bowel disease in the Netherlands 1991–2002: results of a population-based study: the IBD South-Limburg cohort. Inflamm Bowel Dis. 2010;16:1397–1410.CrossRefGoogle Scholar
  7. 7.
    Hutfless SM, Weng X, Liu L, Allison J, Herrinton LJ. Mortality by medication use among patients with inflammatory bowel disease, 1996–2003. Gastroenterology. 2007;133:1779–1786.CrossRefGoogle Scholar
  8. 8.
    Prior P, Fielding JF, Waterhouse JA, Cooke WT. Mortality in Crohn’s disease. Lancet. 1970;1:1135–1137.CrossRefGoogle Scholar
  9. 9.
    Selinger CP, Leong RW. Mortality from inflammatory bowel diseases. Inflamm Bowel Dis. 2012;18:1566–1572.CrossRefGoogle Scholar
  10. 10.
    Canavan C, Abrams KR, Mayberry JF. Meta-analysis: mortality in Crohn’s disease. Aliment Pharmacol Ther. 2007;25:861–870.CrossRefGoogle Scholar
  11. 11.
    Duricova D, Pedersen N, Elkjaer M, Gamborg M, Munkholm P, Jess T. Overall and cause-specific mortality in Crohn’s disease: a meta-analysis of population-based studies. Inflamm Bowel Dis. 2010;16:347–353.CrossRefGoogle Scholar
  12. 12.
    Jess T, Gamborg M, Munkholm P, Sorensen TI. Overall and cause-specific mortality in ulcerative colitis: meta-analysis of population-based inception cohort studies. Am J Gastroenterol. 2007;102:609–617.CrossRefGoogle Scholar
  13. 13.
    Bewtra M, Kaiser LM, TenHave T, Lewis JD. Crohn’s disease and ulcerative colitis are associated with elevated standardized mortality ratios: a meta-analysis. Inflamm Bowel Dis. 2013;19:599–613.CrossRefGoogle Scholar
  14. 14.
    Masala G, Bagnoli S, Ceroti M, et al. Divergent patterns of total and cancer mortality in ulcerative colitis and Crohn’s disease patients: the Florence IBD study 1978–2001. Gut. 2004;53(9):1309–1313.CrossRefGoogle Scholar
  15. 15.
    Stewenius J, Adnerhill I, Anderson H, et al. Incidence of colorectal cancer and all cause mortality in non-selected patients with ulcerative colitis and indeterminate colitis in Malmo, Sweden. Int J Colorectal Dis. 1995;10:117–122.CrossRefGoogle Scholar
  16. 16.
    Weterman IT, Biemond I, Pena AS. Mortality and causes of death in Crohn’s disease. Review of 50 years’ experience in Leiden University Hospital. Gut. 1990;31:1387–1390.CrossRefGoogle Scholar
  17. 17.
    Card T, Hubbard R, Logan RF. Mortality in inflammatory bowel disease: a population-based cohort study. Gastroenterology. 2003;125:1583–1590.CrossRefGoogle Scholar
  18. 18.
    Ekbom A, Helmick CG, Zack M, Holmberg L, Adami HO. Survival and causes of death in patients with inflammatory bowel disease: a population-based study. Gastroenterology. 1992;103:954–960.CrossRefGoogle Scholar
  19. 19.
    Jess T, Winther KV, Munkholm P, Langholz E, Binder V. Mortality and causes of death in Crohn’s disease: follow-up of a population-based cohort in Copenhagen County, Denmark. Gastroenterology. 2002;122:1808–1814.CrossRefGoogle Scholar
  20. 20.
    Persson PG, Bernell O, Leijonmarck CE, Farahmand BY, Hellers G, Ahlbom A. Survival and cause-specific mortality in inflammatory bowel disease: a population-based cohort study. Gastroenterology. 1996;110:1339–1345.CrossRefGoogle Scholar
  21. 21.
    Winther KV, Jess T, Langholz E, Munkholm P, Binder V. Survival and cause-specific mortality in ulcerative colitis: follow-up of a population-based cohort in Copenhagen County. Gastroenterology. 2003;125:1576–1582.CrossRefGoogle Scholar
  22. 22.
    Hovde O, Smastuen MC, Hoivik ML, et al. Mortality and causes of death in ulcerative colitis: results from 20 years of follow-up in the IBSEN study. Inflamm Bowel Dis. 2016;22:141–145.CrossRefGoogle Scholar
  23. 23.
    Uno H, Yao T, Matsui T, et al. Mortality and cause of death in Japanese patients with Crohn’s disease. Dis Colon Rectum. 2003;46:S15–S21.PubMedGoogle Scholar
  24. 24.
    Viscido A, Bagnardi V, Sturniolo GC, et al. Survival and causes of death in Italian patients with ulcerative colitis. A GISC nationwide study. Dig Liver Dis. 2001;33:686–692.CrossRefGoogle Scholar
  25. 25.
    Langholz E, Munkholm P, Davidsen M, Binder V. Colorectal cancer risk and mortality in patients with ulcerative colitis. Gastroenterology. 1992;103:1444–1451.CrossRefGoogle Scholar
  26. 26.
    Mayberry JF, Newcombe RG, Rhodes J. Mortality in Crohn’s disease. Q J Med. 1980;49:63–68.PubMedGoogle Scholar
  27. 27.
    Probert CS, Jayanthi V, Wicks AC, Mayberry JF. Mortality from Crohn’s disease in Leicestershire, 1972-1989: an epidemiological community based study. Gut. 1992;33:1226–1228.CrossRefGoogle Scholar
  28. 28.
    Cottone M, Magliocco A, Rosselli M, et al. Mortality in patients with Crohn’s disease. Scand J Gastroenterol. 1996;31:372–375.CrossRefGoogle Scholar
  29. 29.
    Farrokhyar F, Swarbrick ET, Grace RH, Hellier MD, Gent AE, Irvine EJ. Low mortality in ulcerative colitis and Crohn’s disease in three regional centers in England. Am J Gastroenterol. 2001;96:501–507.CrossRefGoogle Scholar
  30. 30.
    Canavan C, Abrams KR, Hawthorne B, Mayberry JF. Long-term prognosis in Crohn’s disease: an epidemiological study of patients diagnosed more than 20 years ago in Cardiff. Aliment Pharmacol Ther. 2007;25:59–65.CrossRefGoogle Scholar
  31. 31.
    Saro Gismera C, Lacort Fernandez M, Arguelles Fernandez G, et al. Mortality and causes of death in patients with chronic inflammatory bowel disease in Gijon, Asturias (Spain). Rev Esp Enferm Dig. 1999;91:199–208.PubMedGoogle Scholar
  32. 32.
    Jess T, Loftus EV Jr., Harmsen WS, et al. Survival and cause specific mortality in patients with inflammatory bowel disease: a long term outcome study in Olmsted County, Minnesota, 1940–2004. Gut. 2006;55:1248–1254.CrossRefGoogle Scholar
  33. 33.
    Wolters FL, Russel MG, Sijbrandij J, et al. Crohn’s disease: increased mortality 10 years after diagnosis in a Europe-wide population based cohort. Gut. 2006;55:510–518.CrossRefGoogle Scholar
  34. 34.
    Probert CS, Jayanthi V, Wicks AC, Mayberry JF. Mortality in patients with ulcerative colitis in Leicestershire, 1972–1989. An epidemiological study. Dig Dis Sci. 1993;38:538–541.  https://doi.org/10.1007/BF01316511.CrossRefPubMedGoogle Scholar
  35. 35.
    Gyde S, Prior P, Dew MJ, Saunders V, Waterhouse JA, Allan RN. Mortality in ulcerative colitis. Gastroenterology. 1982;83:36–43.PubMedGoogle Scholar
  36. 36.
    Davoli M, Prantera C, Berto E, Scribano ML, D’Ippoliti D. Mortality among patients with ulcerative colitis: Rome 1970–1989. Eur J Epidemiol. 1997;13:189–194.CrossRefGoogle Scholar
  37. 37.
    Jess T, Riis L, Vind I, et al. Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen, Denmark. Inflamm Bowel Dis. 2007;13:481–489.CrossRefGoogle Scholar
  38. 38.
    Ishibashi N, Hirota Y, Ikeda M, Hirohata T. Ulcerative colitis and colorectal cancer: a follow-up study in Fukuoka, Japan. Int J Epidemiol. 1999;28:609–613.CrossRefGoogle Scholar
  39. 39.
    Palli D, Trallori G, Saieva C, et al. General and cancer specific mortality of a population based. Gut. 1998;42:175–179.CrossRefGoogle Scholar
  40. 40.
    Gilat T, Lilos P, Zemishlany Z, Ribak J, Benaroya Y. Ulcerative colitis in the Jewish population of Tel-Aviv Yafo. III. Clinical course. Gastroenterology. 1976;70:14–19.PubMedGoogle Scholar
  41. 41.
    Dorn SD, Sandler RS. Inflammatory bowel disease is not a risk factor for cardiovascular disease mortality: results from a systematic review and meta-analysis. Am J Gastroenterol. 2007;102:662–667.CrossRefGoogle Scholar
  42. 42.
    Jussila A, Virta LJ, Pukkala E, Farkkila MA. Mortality and causes of death in patients with inflammatory bowel disease: a nationwide register study in Finland. J Crohns Colitis. 2014;8:1088–1096.CrossRefGoogle Scholar
  43. 43.
    Cucino C, Sonnenberg A. Cause of death in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2001;7:250–255.CrossRefGoogle Scholar
  44. 44.
    Kassam Z, Belga S, Roifman I, et al. Inflammatory bowel disease cause-specific mortality: a primer for clinicians. Inflamm Bowel Dis. 2014;20:2483–2492.CrossRefGoogle Scholar
  45. 45.
    Lutgens MW, van Oijen MG, van der Heijden GJ, Vleggaar FP, Siersema PD, Oldenburg B. Declining risk of colorectal cancer in inflammatory bowel disease: an updated meta-analysis of population-based cohort studies. Inflamm Bowel Dis. 2013;19:789–799.CrossRefGoogle Scholar
  46. 46.
    Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut. 2001;48:526–535.CrossRefGoogle Scholar
  47. 47.
    Andersen NN, Jess T. Has the risk of colorectal cancer in inflammatory bowel disease decreased? World J Gastroenterol. 2013;19:7561–7568.CrossRefGoogle Scholar
  48. 48.
    Panhwar MS, Sadeer Al-Kindi EM, Cooper G, Ginwalla M. Risk of myocardial infarction In patients with inflammatory bowel disease. J Am Coll Cardiol. 2018;71:A183.CrossRefGoogle Scholar
  49. 49.
    Veronese V, Oo ZM, Thein ZW, et al. Acceptability of peer-delivered HIV testing and counselling among men who have sex with men (MSM) and transgender women (TW) in Myanmar. AIDS Behav. 2018.Google Scholar
  50. 50.
    O’Toole A, Walsh P, Keegan D, et al. Mortality in inflammatory bowel disease patients under 65 years of age. Scand J Gastroenterol. 2014;49:814–819.CrossRefGoogle Scholar
  51. 51.
    Chu TPC, Moran GW, Card TR. The pattern of underlying cause of death in patients with inflammatory bowel disease in england: a record linkage study. J Crohns Colitis. 2017;11:578–585.PubMedGoogle Scholar
  52. 52.
    Reamy BV, Williams PM, Kuckel DP. Prevention of cardiovascular disease. Prim Care. 2018;45:25–44.CrossRefGoogle Scholar
  53. 53.
    WHO. Cardiovascular Diseases (CVDs). 2017; Available from: http://www.who.int/mediacentre/factsheets/fs317/en/.
  54. 54.
    Wu P, Jia F, Zhang B, Zhang P. Risk of cardiovascular disease in inflammatory bowel disease. Exp Ther Med. 2017;13:395–400.CrossRefGoogle Scholar
  55. 55.
    Aniwan S, Pardi DS, Tremaine WJ, Loftus EV Jr. Increased risk of acute myocardial infarction and heart failure in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2018;16:1607–1615.CrossRefGoogle Scholar
  56. 56.
    Nordenholtz KE, Stowe SP, Stormont JM, et al. The cause of death in inflammatory bowel disease: a comparison of death certificates and hospital charts in Rochester, New York. Am J Gastroenterol. 1995;90(6):927–932.PubMedGoogle Scholar
  57. 57.
    D’Haens G, Baert F, van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn’s disease: an open randomised trial. Lancet. 2008;371:660–667.CrossRefGoogle Scholar
  58. 58.
    Loftus EV Jr., Silverstein MD, Sandborn WJ, Tremaine WJ, Harmsen WS, Zinsmeister AR. Crohn’s disease in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival. Gastroenterology. 1998;114:1161–1168.CrossRefGoogle Scholar
  59. 59.
    Delaunoit T, Limburg PJ, Goldberg RM, Lymp JF, Loftus EV Jr. Colorectal cancer prognosis among patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2006;4:335–342.CrossRefGoogle Scholar
  60. 60.
    Wi CI, St Sauver JL, Jacobson DJ, et al. Ethnicity, socioeconomic status, and health disparities in a Mixed Rural-Urban US Community-Olmsted County, Minnesota. Mayo Clin Proc. 2016;91:612–622.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Angelica Nocerino
    • 1
  • Alexandra Feathers
    • 1
  • Elena Ivanina
    • 1
  • Laura Durbin
    • 1
  • Arun Swaminath
    • 1
  1. 1.Division of GastroenterologyLenox Hill HospitalNew YorkUSA

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