Crohn's disease: Increased mortality 10 years after diagnosis in a Europe-wide population based cohort

Maastricht University, Maestricht, Limburg, Netherlands
Gut (Impact Factor: 14.66). 05/2006; 55(4):510-8. DOI: 10.1136/gut.2005.072793
Source: PubMed


No previous correlation between phenotype at diagnosis of Crohn's disease (CD) and mortality has been performed. We assessed the predictive value of phenotype at diagnosis on overall and disease related mortality in a European cohort of CD patients.
Overall and disease related mortality were recorded 10 years after diagnosis in a prospectively assembled, uniformly diagnosed European population based inception cohort of 380 CD patients diagnosed between 1991 and 1993. Standardised mortality ratios (SMRs) were calculated for geographic and phenotypic subgroups at diagnosis.
Thirty seven deaths were observed in the entire cohort whereas 21.5 deaths were expected (SMR 1.85 (95% CI 1.30-2.55)). Mortality risk was significantly increased in both females (SMR 1.93 (95% CI 1.10-3.14)) and males (SMR 1.79 (95% CI 1.11-2.73)). Patients from northern European centres had a significant overall increased mortality risk (SMR 2.04 (95% CI 1.32-3.01)) whereas a tendency towards increased overall mortality risk was also observed in the south (SMR 1.55 (95% CI 0.80-2.70)). Mortality risk was increased in patients with colonic disease location and with inflammatory disease behaviour at diagnosis. Mortality risk was also increased in the age group above 40 years at diagnosis for both total and CD related causes. Excess mortality was mainly due to gastrointestinal causes that were related to CD.
This European multinational population based study revealed an increased overall mortality risk in CD patients 10 years after diagnosis, and age above 40 years at diagnosis was found to be the sole factor associated with increased mortality risk.

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Available from: Leo J Schouten, Oct 10, 2015
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    • "Következésképp az előnyök és kockázatok gondos mérlegelésével, egyedi elbírálást követően kell megválasztanunk a kezelési stratégiát. Több vizsgálat is a Crohn-betegek mortalitásának emelkedéséről számol be az átlagpopulációhoz képest [17] [18]. Azonban egy közelmúltban megjelent közleményben a gyermekkorban induló IBD-ben szenvedő betegek halálozási arányát nem találták magasabbnak az átlagpopulációhoz képest az átlagos 11 éves utánkövetés alatt. "
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    Orvosi Hetilap 05/2014; 155(20):789-92. DOI:10.1556/OH.2014.29892
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    • "In a European multinational population-based study, Wolters et al. revealed an increased mortality risk in CD patients 10 years after diagnosis. Age over 40 years at diagnosis was the sole factor associated with increased mortality risk [4]. Although cellular and biological methods have greatly improved our understanding of the pathogenesis of CD [5]–[8], no single distinct mechanism can explain all aspects of this disease. "
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    ABSTRACT: Incidences of Crohn disease (CD) have increased significantly in the last decade. Immunoproteomics are a promising method to identify biomarkers of different diseases. In the present study, we used immunoproteomics to study proteins of intestinal mucosal lesions and neighboring normal intestinal mucosa of 8 CD patients. Reactive proteins were validated by Western blotting. Approximately 50 protein spots localized in the 4 to 7 pI range were detected on two-dimensional electrophoresis gels, and 6 differentially expressed protein spots between 10 and 100 kDa were identified. Reactive proteins were identified as prohibitin, calreticulin, apolipoprotein A-I, intelectin-1, protein disulfide isomerase, and glutathione s-transferase Pi. Western blotting was conducted on the intestinal mucosa of another 4 CD patients to validate the reactive proteins. We found that intestinal mucosal lesions had high levels of prohibitin expression. Glutathione s-transferase expression was detected in 100% of the intestinal mucosa examined. Thus, we report 6 autoantigens of CD, including 3 new and 3 previously reported autoantigens. Intelectin-1, protein disulfide isomerase, and glutathione-s-transferases may be used as biomarkers for CD pathogenesis.
    PLoS ONE 12/2013; 8(12):e81662. DOI:10.1371/journal.pone.0081662 · 3.23 Impact Factor
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    • "In general, the disease course of UC is more severe in elderly patients and mortality in hospitalized patients, both with UC and CD, is estimated to be 3–5 times higher than in age subgroups <65 years [4]. In UC, age at diagnosis is not associated with increased mortality, whereas in CD, there is a slight increase in the risk of mortality in older patients (>55 years) with long-standing disease [20]. "
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