Crohn’s disease ups risk of death: study

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The risk of death is increased 10 years after the diagnosis of Crohn’s disease in both men and women, according to a European population-based study.

Crohn’s disease is an inflammation in the digestive tract that affects about a million people worldwide, many between age 15 and 35 years of age. It is not clear what causes it.

Among a group of 380 Crohn’s disease patients, there were 37 deaths over a 10-year period, versus 21.5 expected in the general population, Dr. F. L. Wolters from University Hospital Maastricht, the Netherlands, and colleagues report in the April issue of Gut, a medical journal.

Mortality risk was significantly increased in both women and men.

Age older than 40 years at the time of Crohn’s disease diagnosis was the only independent risk factor for death. Consistent with prior similar studies, the increased risk of death was largely due to gastrointestinal causes related to Crohn’s disease.

Mortality risk varied somewhat by geographic area with Crohn’s patients from northern European centers having a significant twofold overall increased mortality risk whereas a “tendency towards increased overall mortality risk” was observed in southern European centers.

Wolters and colleagues say it’s interesting to note that the use of corticosteroids did not differ between the northern and southern European centers, but the use of immunosuppressive drug azathioprine did. Of 237 patients from northern Europe, 74 (31 percent) had used azathioprine compared with 21 of 121 patients (17 percent) from southern Europe.

“The use of immunosuppressive drugs could be interpreted as a surrogate marker of disease severity and hence, given the percentages of patients in whom azathioprine was considered to be indicated, disease phenotype might be estimated as more severe in the north of Europe as compared with the south,” they offer.

SOURCE: Gut, April 2006.

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