Abstract
BackgroundIn this study, survival and cause of death were investigated in patients with Crohn’s disease (CD) at a tertiary referral center.MethodsA 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.ResultsThe 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.ConclusionThe 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.
Highlights
Crohn’s disease (CD) is a chronic inflammatory bowel disease (IBD) of unknown etiology
A database based on the medical records of CD patients at our hospital with the addition of information obtained from a questionnaire survey was created, and the long-term prognosis of CD patients was investigated
A questionnaire survey was distributed to 303 CD patients who did not have a history of visiting our hospital for at least 3 years, and information on their present condition, cause of death, last observed day, smoking history, surgical history, and previously used medications was added from the 106 responses
Summary
Crohn’s disease (CD) is a chronic inflammatory bowel disease (IBD) of unknown etiology. It often develops at an early age and can affect the entire gastrointestinal tract from the oral cavity to the anus. A database based on the medical records of CD patients at our hospital with the addition of information obtained from a questionnaire survey was created, and the long-term prognosis of CD patients was investigated. 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. Abbreviations CD Crohn’s disease CI Confidence interval CRC Colorectal cancer HPN Home parenteral nutrition HR Hazard ratio IBD Inflammatory bowel disease ICD International Classification of Diseases IF Intestinal failure SMR Standardized mortality ratio SIR Standardized incidence ratio TNF Tumor necrosis factor
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