Bitton Alain, Vutcovici Maria, Sewitch Maida, Suissa Samy, Brassard Paul
*Division of Gastroenterology, McGill University Health Centre, Montréal, QC, Canada; †Department of Medicine, McGill University, Montréal, QC, Canada; and ‡Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.
Inflamm Bowel Dis. 2016 Feb;22(2):416-23. doi: 10.1097/MIB.0000000000000608.
Mortality rates greater than in the general population have been reported in the population with Crohn's disease (CD), but reports for ulcerative colitis (UC) are conflicting. Trends with time were rarely described. We aimed to assess whether CD and UC mortality in Québec differs from that in the general population and to describe the trends over a 10-year observation period.
This is a population-based cohort study using the Québec administrative health databases and death certificates registry. All-cause and cause-specific standardized mortality ratios (SMRs) were computed for 1999 to 2008. A time trend analysis was used to assess changes in the SMR with the calendar year.
All-cause mortality was significantly increased in CD and UC compared to the general population: SMR: CD 1.45 (95% confidence interval: 1.34-1.58), UC 1.21 (95% confidence interval: 1.12-1.32). In CD, mortality from digestive conditions, all neoplasms, digestive neoplasms, and colorectal, lymphatic, and lung cancer was significantly higher than in the general population. In UC, mortality from digestive, respiratory, and infectious conditions was also significantly increased. In both CD and UC, there was a decrease with time in all-cause SMRs and in digestive conditions, digestive neoplasms, colorectal cancer, and infectious diseases. SMRs for lung cancer and respiratory conditions increased over time in CD.
All-cause mortality was significantly higher in CD and UC populations than in the general population. However, a decreasing trend with time was observed in all-cause and some cause-specific SMRs. In CD, SMRs for lung cancer and respiratory conditions increased during the observation period.
据报道，克罗恩病（CD）患者的死亡率高于普通人群，但关于溃疡性结肠炎（UC）的报道存在矛盾。很少有关于随时间变化趋势的描述。我们旨在评估魁北克省CD和UC的死亡率是否与普通人群不同，并描述10年观察期内的趋势。
这是一项基于人群的队列研究，使用魁北克省行政卫生数据库和死亡证明登记处。计算了1999年至2008年全因和特定病因的标准化死亡率（SMR）。采用时间趋势分析评估SMR随日历年的变化。
与普通人群相比，CD和UC的全因死亡率显著增加：SMR：CD为1.45（95%置信区间：1.34 - 1.58），UC为1.21（95%置信区间：1.12 - 1.32）。在CD中，消化系统疾病、所有肿瘤、消化系统肿瘤以及结直肠癌、淋巴癌和肺癌的死亡率显著高于普通人群。在UC中，消化系统、呼吸系统和感染性疾病的死亡率也显著增加。在CD和UC中，全因SMR以及消化系统疾病、消化系统肿瘤、结直肠癌和传染病的SMR均随时间下降。CD中肺癌和呼吸系统疾病的SMR随时间增加。
CD和UC人群的全因死亡率显著高于普通人群。然而，全因和一些特定病因的SMR随时间呈下降趋势。在CD中，观察期内肺癌和呼吸系统疾病的SMR增加。
