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P180 Cause-specific and trend of mortality analysis in patients with inflammatory bowel disease: a Taiwanese Nationwide population-based study

S. C. Wei*1, W. C. Lin2, M. T. Weng3, C. C. Tung4, Y. T. Chang5, Y. L. Leong6, Y. T. Wang7, H. Y. Wang2, J. M. Wong4

1National Taiwan University Hospital and College of Medicine, Internal Medicine, Taipei, Taiwan, 2Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan, 3Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan, 4Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 5Health Data Research Center, National Taiwan University, Taipei, Taiwan, 6Department of Internal Medicine, West Garden Hospital, Taipei, Taiwan, 7Inflammatory Bowel Disease Clinical and Study Integrated Center, National Taiwan University Hospital, Taipei, Taiwan

Background

Our previous study reported a higher mortality rate from inflammatory bowel disease (IBD) in Taiwan than in Western countries. With advancement in diagnosis and treatment for IBD, we proposed to compare the trend of mortality change and analyse cause-specific mortality in Taiwan.

Methods

This retrospective study was conducted to analyse data for January 2001 to December 2015 from a registered database, compiled by the Taiwan's National Health Insurance.

Results

Between 2001 and 2015, a total of 3806 IBD patients [Crohn’s disease (CD): 919; ulcerative colitis (UC): 2887] were registered as having catastrophic illness, and 8.2% of these patients died during follow-up. The overall mortality rates for CD and UC were 20.0 and 10.8 per 1000 person-years, respectively. The standardised mortality ratios (SMRs) of CD and UC were 3.72 (95% CI: 3.02–4.55) and 1.44 (95% CI: 1.26–1.65), respectively, from 2001 to 2015, respectively (Table 1, Figure 1).

Table 1. Mortality in IBD patients registered in Catastrophic Illness Registry between 2001 and 2015, Taiwan.

Figure 1. Survival rate of patients registered in the Catastrophic Illness Registry with IBD, Taiwan, 2001–2015.

A comparison of the periods of 2011–2015 and 2001–2005 revealed a decrease in the mortality rates from both UC and CD (Figure 2).

Figure 2. Standard mortality ratio of (A) Crohn’s disease and (B) ulcerative colitis in different time periods.

Regarding cause-specific mortality in IBD patients, elderly individuals; comorbidities such as hypertension, diabetes, and chronic obstructive pulmonary disease; infections; IBD-related complications; malignancies; and surgeries were the risk factors for mortality (Table 2).

Abstract PO180 – Table 2. Age-adjusted cause-specific mortality of IBD patients registered in the Catastrophic Illness Registry, Taiwan, 2001–2015.

Conclusion

In this nationwide population-based Taiwanese study, although SMRs of IBD patients decreased from 2001 to 2015, they were still higher than those of the general population. For further decreasing IBD-related mortality in Taiwan, we need to pay special attention towards elderly individuals, infection control, and improvement in perioperative care.