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P327. Mortality from inflammatory bowel disease in a healthcare area of Gijon, Spain: Results from the study of a hospital registry from 1992 to 2006

C. Saro Gismera IV1, C. de la Coba1, F. Roman1, R. García1, M. Posadilla1, R. Tojo1, A. Álvarez1, P. Varela1, J. Perez-Pariente1, I. Méndez2, P. Lázaro3

1Hospital of Cabueñes, Gijón-Asturias, Spain; 2Técnicas avanzadas de Investigación en Servicios de Salud (TAISS), Madrid, Spain; 3TAISS, Madrid, Spain

Aim: Study of mortality, IBD related mortality and survival related factors in IBD patients from a Healthcare area at Gijón, Spain.

Materials and Methods: Design: Hospital Registry of data from all IBD patients treated from 1992 to 2006 at different hospitals of the Healthcare area of the Cabueñes Hospital. A descriptive study was performed for all cause mortality and of IBD related deaths from data for the whole sample. IBD survival and its related factors were studied by Cox regression techniques. Mortality and the Standardized Mortality Ratio (SMR) were computed after an aggregation by sex, age at dead, and periods of five years. Mortality rates were studied with Poisson regression techniques. Demographic data of the area population were collected from national and local statistical sources. The standardization was made with data from the CE-15 European population.

Results: The registry included data from 1,134 patients of IBD, of which 373 (32.9%) were diagnosed before 1992. It consisted of 498 Crohn Disease (CD) (43.9%), 605 Ulcerative Colitis (UC) (53.3%), and 31 Undetermined Colitis (UNC) (2.7%) patients. Deaths for all causes were 106 (9.3%), being 40 (8.0%) in CD patients, 65 (10.8%) in UC patients, and 1 (3.2%) in the UNC group. Of them, 14 deaths (13.2% of all deaths; 7 in CD and 7 in UC patients) were related with IBD. Patients whose death was related to IBD had shorter progression time of their disease, and were more likely to have suffered from IBD related tumours. Within patients dead by IBD, CD patients were diagnosed at later ages, whereas CU patients were more likely to have a pancolic extension of their lesions. Cox' survival models showed higher hazard ratios between those who were older at diagnosis, and who developed IBD related tumours. Being diagnosed later, after longer periods with IBD symptoms, showed an almost significant slight rising trend in mortality. SMR for all deaths for the whole period was 0.77 (CI95% = 0.63–0.94), which is not higher than that from the general population mortality. SMR for CD was 1.00 (CI95% = 0.71–1.37), and for UC 0.69 (CI95% = 0.53–0.88). The study of SMR along the study period did not show differences with the general population. IBD related mortality was associated with being older than 60 years, and it decreased in the last 5 years of the study.

Conclusion: Mortality between IBD patients is not different from that of the general population. However, those who die from IBD related causes are diagnosed later, at an older age, have a shorter evolution of their disease, and developed tumours related with IBD at a higher rate.