Mortality by Medication Use Among Patients With Inflammatory Bowel Disease, 1996-2003

Susan Hutfless, Xiaoping Weng, Liyan Liu, James Allison, Lisa J. Herrinton

Research output: Contribution to journalArticle

Abstract

Background & Aims: Most previous population-based studies of mortality in inflammatory bowel disease (IBD) did not account for medication use. We evaluated mortality by IBD medication use among members of the Kaiser Permanente Northern California IBD Registry. Methods: The retrospective, population-based cohort study included 9032 persons who received at least one inpatient or 2 outpatient diagnoses of IBD during 1996-2002. Age and sex standardized mortality ratios measured the associations between IBD and all-cause and cause-specific mortality. Age, sex, and smoking adjusted odds ratios measured the association of mortality by IBD medication use. Results: Compared with health plan members without IBD, mortality was increased in patients with Crohn's disease (CD) (1.4; 95% confidence interval, 1.2-1.6) but not ulcerative colitis (UC) (1.0; 95% CI, 0.9-1.2). CD was associated with increased mortality from infectious and parasitic diseases (4.1; 95% CI, 1.7-8.5), septicemia (6.8; 95% CI, 2.2-15.8), small intestinal cancer (48.1; 95% CI, 5.8-17.4), respiratory diseases (1.9; 95% CI, 1.3-2.7), digestive diseases other than IBD (2.4; 95% CI, 1.0-4.8), and liver diseases (2.6; 95% CI, 1.0-5.3). UC was associated with increased mortality from digestive diseases other than IBD (3.9; 95% CI, 2.4-6.0). The relationship with CD mortality was 0.7 for aminosalicylates (95% CI, 0.5-1.1), 1.3 (95% CI, 0.9-1.9) for immunomodulators, and 1.0 (95% CI, 0.7-1.4) for corticosteroids. Among patients with UC, these odds ratios were 0.8 (95% CI, 0.5-1.1) for aminosalicylates, 0.5 (95% CI, 0.3-0.9) for immunomodulators, and 0.8 (95% CI, 0.6-1.1) for corticosteroids. Conclusions: Mortality is increased in CD. Infections, respiratory diseases, and digestive diseases are important specific causes of death. IBD medication use has varying associations with mortality.

Original languageEnglish (US)
Pages (from-to)1779-1786
Number of pages8
JournalGastroenterology
Volume133
Issue number6
DOIs
StatePublished - Dec 2007
Externally publishedYes

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Inflammatory Bowel Diseases
Mortality
Crohn Disease
Ulcerative Colitis
Immunologic Factors
Adrenal Cortex Hormones
Odds Ratio
Intestinal Neoplasms
Parasitic Diseases
Respiratory Tract Infections
Population
Communicable Diseases
Registries
Liver Diseases
Inpatients
Cause of Death
Sepsis
Cohort Studies
Outpatients
Smoking

ASJC Scopus subject areas

  • Gastroenterology

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Mortality by Medication Use Among Patients With Inflammatory Bowel Disease, 1996-2003. / Hutfless, Susan; Weng, Xiaoping; Liu, Liyan; Allison, James; Herrinton, Lisa J.

In: Gastroenterology, Vol. 133, No. 6, 12.2007, p. 1779-1786.

Research output: Contribution to journalArticle

Hutfless, Susan ; Weng, Xiaoping ; Liu, Liyan ; Allison, James ; Herrinton, Lisa J. / Mortality by Medication Use Among Patients With Inflammatory Bowel Disease, 1996-2003. In: Gastroenterology. 2007 ; Vol. 133, No. 6. pp. 1779-1786.
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title = "Mortality by Medication Use Among Patients With Inflammatory Bowel Disease, 1996-2003",
abstract = "Background & Aims: Most previous population-based studies of mortality in inflammatory bowel disease (IBD) did not account for medication use. We evaluated mortality by IBD medication use among members of the Kaiser Permanente Northern California IBD Registry. Methods: The retrospective, population-based cohort study included 9032 persons who received at least one inpatient or 2 outpatient diagnoses of IBD during 1996-2002. Age and sex standardized mortality ratios measured the associations between IBD and all-cause and cause-specific mortality. Age, sex, and smoking adjusted odds ratios measured the association of mortality by IBD medication use. Results: Compared with health plan members without IBD, mortality was increased in patients with Crohn's disease (CD) (1.4; 95{\%} confidence interval, 1.2-1.6) but not ulcerative colitis (UC) (1.0; 95{\%} CI, 0.9-1.2). CD was associated with increased mortality from infectious and parasitic diseases (4.1; 95{\%} CI, 1.7-8.5), septicemia (6.8; 95{\%} CI, 2.2-15.8), small intestinal cancer (48.1; 95{\%} CI, 5.8-17.4), respiratory diseases (1.9; 95{\%} CI, 1.3-2.7), digestive diseases other than IBD (2.4; 95{\%} CI, 1.0-4.8), and liver diseases (2.6; 95{\%} CI, 1.0-5.3). UC was associated with increased mortality from digestive diseases other than IBD (3.9; 95{\%} CI, 2.4-6.0). The relationship with CD mortality was 0.7 for aminosalicylates (95{\%} CI, 0.5-1.1), 1.3 (95{\%} CI, 0.9-1.9) for immunomodulators, and 1.0 (95{\%} CI, 0.7-1.4) for corticosteroids. Among patients with UC, these odds ratios were 0.8 (95{\%} CI, 0.5-1.1) for aminosalicylates, 0.5 (95{\%} CI, 0.3-0.9) for immunomodulators, and 0.8 (95{\%} CI, 0.6-1.1) for corticosteroids. Conclusions: Mortality is increased in CD. Infections, respiratory diseases, and digestive diseases are important specific causes of death. IBD medication use has varying associations with mortality.",
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AU - Allison, James

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N2 - Background & Aims: Most previous population-based studies of mortality in inflammatory bowel disease (IBD) did not account for medication use. We evaluated mortality by IBD medication use among members of the Kaiser Permanente Northern California IBD Registry. Methods: The retrospective, population-based cohort study included 9032 persons who received at least one inpatient or 2 outpatient diagnoses of IBD during 1996-2002. Age and sex standardized mortality ratios measured the associations between IBD and all-cause and cause-specific mortality. Age, sex, and smoking adjusted odds ratios measured the association of mortality by IBD medication use. Results: Compared with health plan members without IBD, mortality was increased in patients with Crohn's disease (CD) (1.4; 95% confidence interval, 1.2-1.6) but not ulcerative colitis (UC) (1.0; 95% CI, 0.9-1.2). CD was associated with increased mortality from infectious and parasitic diseases (4.1; 95% CI, 1.7-8.5), septicemia (6.8; 95% CI, 2.2-15.8), small intestinal cancer (48.1; 95% CI, 5.8-17.4), respiratory diseases (1.9; 95% CI, 1.3-2.7), digestive diseases other than IBD (2.4; 95% CI, 1.0-4.8), and liver diseases (2.6; 95% CI, 1.0-5.3). UC was associated with increased mortality from digestive diseases other than IBD (3.9; 95% CI, 2.4-6.0). The relationship with CD mortality was 0.7 for aminosalicylates (95% CI, 0.5-1.1), 1.3 (95% CI, 0.9-1.9) for immunomodulators, and 1.0 (95% CI, 0.7-1.4) for corticosteroids. Among patients with UC, these odds ratios were 0.8 (95% CI, 0.5-1.1) for aminosalicylates, 0.5 (95% CI, 0.3-0.9) for immunomodulators, and 0.8 (95% CI, 0.6-1.1) for corticosteroids. Conclusions: Mortality is increased in CD. Infections, respiratory diseases, and digestive diseases are important specific causes of death. IBD medication use has varying associations with mortality.

AB - Background & Aims: Most previous population-based studies of mortality in inflammatory bowel disease (IBD) did not account for medication use. We evaluated mortality by IBD medication use among members of the Kaiser Permanente Northern California IBD Registry. Methods: The retrospective, population-based cohort study included 9032 persons who received at least one inpatient or 2 outpatient diagnoses of IBD during 1996-2002. Age and sex standardized mortality ratios measured the associations between IBD and all-cause and cause-specific mortality. Age, sex, and smoking adjusted odds ratios measured the association of mortality by IBD medication use. Results: Compared with health plan members without IBD, mortality was increased in patients with Crohn's disease (CD) (1.4; 95% confidence interval, 1.2-1.6) but not ulcerative colitis (UC) (1.0; 95% CI, 0.9-1.2). CD was associated with increased mortality from infectious and parasitic diseases (4.1; 95% CI, 1.7-8.5), septicemia (6.8; 95% CI, 2.2-15.8), small intestinal cancer (48.1; 95% CI, 5.8-17.4), respiratory diseases (1.9; 95% CI, 1.3-2.7), digestive diseases other than IBD (2.4; 95% CI, 1.0-4.8), and liver diseases (2.6; 95% CI, 1.0-5.3). UC was associated with increased mortality from digestive diseases other than IBD (3.9; 95% CI, 2.4-6.0). The relationship with CD mortality was 0.7 for aminosalicylates (95% CI, 0.5-1.1), 1.3 (95% CI, 0.9-1.9) for immunomodulators, and 1.0 (95% CI, 0.7-1.4) for corticosteroids. Among patients with UC, these odds ratios were 0.8 (95% CI, 0.5-1.1) for aminosalicylates, 0.5 (95% CI, 0.3-0.9) for immunomodulators, and 0.8 (95% CI, 0.6-1.1) for corticosteroids. Conclusions: Mortality is increased in CD. Infections, respiratory diseases, and digestive diseases are important specific causes of death. IBD medication use has varying associations with mortality.

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