Risk of age-related and disease-related complications and mortality in elderly-onset IBD - a population-based study.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology Pub Date : 2025-03-13 DOI:10.1016/j.cgh.2025.01.020

Dana Ben Hur, Guy Issaschar, Ran Moshe, Boris Lebedenko, Rona Lujan, Ziona Haklai, Yiska Loewenberg Weisband, Amir Ben-Tov, Natan Lederman, Eran Matz, Iris Dotan, Dan Turner, Gabriel D Pinto, Matti Waterman

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引用次数: 0

Abstract

Background & aims: In this nationwide cohort from Israel (Epi-IIRN), we aimed to characterize risks for age-related complications, mortality and IBD-related surgeries in patients with elderly-onset inflammatory bowel diseases (EO-IBD).

Methods: Data of patients with EO-IBD (≥65 years) diagnosed during 2005-2020 were retrieved from the epi-IIRN database. EO-IBD Patients were compared to 3 age-, sex- and district-matched non-IBD individuals, for age-related outcomes. Incident EO-IBD patients were matched to 4 adult-onset (AO) IBD (≥18<65 years) by IBD-subtype-, sex- and district. Cumulative incidence functions were calculated to estimate event probabilities over time accounting for death as a competing risk. Proportional subdistribution hazards models were used to assess predictors of medication use, surgery and complications.

Results: Of 2,826 EO-IBD cases, 2,162 had 3 matched non-IBD controls. Mortality rates/1000 PY were similar in EO-IBD and non-IBD controls (292.32 (273.53-311.85) vs.291.24 (280.31-302.42), respectively) as were mortality causes and risk (aHR, 95% CI) for pneumonia 1.04 (0.84-1.29), fractures 1.03 (0.82-1.29), bacteremia 2.16 (0.87-5.40) and thromboembolism 0.58 (0.27-1.23). When matching 2,826 EO-IBD to 11,304 AO-IBD, EO-IBD had lower exposure to thiopurines (aHR= 0.44 [0.39-0.49], and anti-TNF (aHR=0.37 [0.32-0.42] and higher risk for abdominal surgery (aHR=1.23 [1.04-1.46] in CD, aHR=1.51 [2.04-3.08] in UC, respectively) but lower perianal surgery risk (HR=0.27 [0.16-0.47]) in CD. The calculated frequencies of repeat perianal and abdominal surgery in EO-CD and AO-CD at 3 years were 7.1% vs. 36%, respectively and 29% and 21%, respectively.

Conclusions: Compared with non-IBD elderly, EO-IBD have similar risk for death and complications. Compared to AO-IBD, EO-IBD are at higher risk for abdominal surgery, but not for perianal surgery.

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背景与目的在以色列全国性队列（Epi-IIRN）中，我们旨在描述老年炎症性肠病患者（EO-IBD）中与年龄相关的并发症、死亡率和 IBD 相关手术的风险特征：从 epi-IIRN 数据库中检索了 2005-2020 年间确诊的 EO-IBD 患者（≥65 岁）的数据。将 EO-IBD 患者与 3 名年龄、性别和地区匹配的非 IBD 患者进行比较，以了解与年龄相关的结果。发病的 EO-IBD 患者与 4 名成人发病型 (AO) IBD 患者（≥18 岁）进行配对：在 2,826 例 EO-IBD 病例中，2,162 例有 3 个匹配的非 IBD 对照。EO-IBD 和非 IBD 对照组的死亡率/1000 PY 相似（分别为 292.32 (273.53-311.85) vs.291.24 (280.31-302.42)），死亡原因和风险（aHR，95% CI）分别为肺炎 1.04 (0.84-1.29)、骨折 1.03 (0.82-1.29)、菌血症 2.16 (0.87-5.40) 和血栓栓塞 0.58 (0.27-1.23)。将 2,826 例 EO-IBD 与 11,304 例 AO-IBD 进行比对时，EO-IBD 的硫嘌呤暴露较低（aHR= 0.44 [0.39-0.49] ，抗肿瘤坏死因子暴露较低（aHR=0.37 [0.32-0.42]，腹部手术风险较高（CD 的 aHR=1.23 [1.04-1.46]，UC 的 aHR=1.51 [2.04-3.08]），但 CD 的肛周手术风险较低（HR=0.27 [0.16-0.47]）。计算得出的EO-CD和AO-CD在3年内重复肛周和腹部手术的频率分别为7.1%对36%，29%对21%：结论：与非肛周疾病老人相比，EO-肛周疾病老人的死亡和并发症风险相似。与AO-IBD相比，EO-IBD接受腹部手术的风险更高，但接受肛周手术的风险并不高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

16.90

自引率

4.80%

发文量

903

审稿时长

22 days

期刊介绍： Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.