A 10 Year Review of the Death Rate and Cause of Death Within a DGH Cohort of IBD Patients .

1. A 10 Year Review of the Death Rate and Cause of Death Within a DGH Cohort of IBD Patients. M. W. Johnson, K. Lithgo, T. Prouse, T. Price Gastroenterology Department, Luton & Dunstable University Hospital, Luton. LU40DZ. UK. Conclusions The Office for National Statistics stated that in 2010 the average lifespan in England and Wales, for men and women, was 85 and 89 years, respectively. The life expectancy in Luton is slightly lower than the national average by approximately 2 years (Annual Public Health Report 2012-2013). The average age of death in our IBD cohort appears substantially lower than that, at approximately 80 years of age. A study performed in New York in 1995, noted that 68% of Crohn’s patients and 78% of UC patients died from causes unrelated to their IBD2. Colorectal cancer was only related to the cause of death in 14% of UC patients and 4.5% of Crohn’s patients. In this study a wide variety of cause were found, but just 41 of the 186 (22%) appeared to be directly related to gastrointestinal disease, whilst gastrointestinal cancer was listed as the cause of death in just 9 (4.8%). A study performed in New Mexico found that a large number of deaths were associated with medical and surgical interventions. In our study infection (sepsis and pneumonia) appeared to be the single most common cause of mortality 60/186 (37.5%), raising questions about a possible iatrogenic contribution. References 1) T. Jess. Trends in overall cause mortality among patients with IBD 1982 - 2010. Clin Gastro + Hep. 2013; 11: 43-48. 2) Nordenholtz K.E. The cause of death in IBD: a comparison of death certificates and hospital charts in Rochester, New York. Am J Gastroenterol. 1995 Jun; 90(6): 927-32 3) Cucino C. Cause of death in patients with IBD. IBD. 2001 Aug; 7(£): 250-5 Results In total 2640 patients with IBD were identified and 186 (7%) of these died between 2001 and 2011. The average age at death was 80 years. The cause of death ranged considerably (see chart below). Sixty of the 186 deaths (32%) were due to infection. Table 1: The main causes of death listed in the hospital record system for 186 IBD patients over a 10y period Introduction Whilst there is a growing body of data supporting the increased risk of colo-rectal cancer in patients with inflammatory bowel disease, little has been written about the overall mortality and cause of death seen in patients with this condition. In a large Scandinavian study the mortality rate for IBD patients was found to be significantly higher than that seen in the general population1. The mortality rate for Crohn’s patients was found to be 50% higher than that of the general population whilst UC patients had a mortality rate 10% higher than the general population. This mortality was greatest in the first year after diagnosis. Over the last decade improvements have been made, and this is thought secondary to reductions in mortality from colorectal cancer, gastrointestinal disorders and suicide. Aims To assess the death rate and cause of death noted in our cohort of IBD patients over a 10 year period. Methods 1 A database of all known local IBD patients was established after retrospectively reviewing 37,000 colonoscopy and flexible sigmoidoscopy reports performed at the Luton & Dunstable University Hospital between 2001 and 2011. Histological assessment was then used to cross correlate all patients diagnosed with colitis. The hospital coding officer analysed the database and provided details on all deaths within the cohort over the time period, and the cause of death as listed by the hospital record system.