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P726 High mortality risk after first hospital admission for inflammatory bowel disease: a nationwide registry linkage study

Opstelten J.*1, Vaartjes I.2, Siersema P.3, Bots M.2, Oldenburg B.1

1University Medical Centre Utrecht, Department of Gastroenterology and Hepatology, Utrecht, Netherlands 2University Medical Centre Utrecht, Julius Centre for Health Sciences and Primary Care, Utrecht, Netherlands 3Radboud University Medical Centre, Department of Gastroenterology and Hepatology, Nijmegen, Netherlands

Background

The aims of this study were to determine the incidence of hospitalization for inflammatory bowel disease (IBD) and to determine outcomes after hospital admission.

Methods

A cohort of patients who were admitted to the hospital because of IBD for the first time between 1995 and 2010 was identified by linkage of nationwide Dutch registries. Incidence rates, mortality risks and causes of death for Crohn's disease (CD) and ulcerative colitis (UC) were assessed. Cox regression models were used to determine differences between CD and UC.

Results

A total of 28,843 individuals (56.0% men, mean age 47.7 years) were at least once hospitalized for IBD. Incidence rates of hospital admission increased from 7.18 to 8.28 per 100,000 person-years in CD and from 5.71 to 6.30 per 100,000 person-years in UC. During a mean follow-up of 5.69 years, all-cause mortality was 15.9% and 21.5% after hospital admission for CD and UC, respectively. Main causes of death were cancer and cardiovascular disease. Patients admitted for UC had a lower risk of all-cause mortality (adjusted relative risk [RR] 0.88, 95% confidence interval [CI] 0.83–0.92), death from cardiovascular disease (adjusted RR 0.89, 95% CI 0.80–0.98) and death from cancer (adjusted RR 0.81, 95% CI 0.74–0.89) than those admitted for CD. No difference in risk of death from colon cancer between CD and UC was observed (adjusted RR 0.89, 95% CI 0.70–1.12).

Conclusion

The incidence of hospitalization for IBD did not decrease over time and the all-cause mortality risk of patients after first admission to the hospital was high.