Posts Tagged ‘Survival’

Crohns Disease Life Expectancy

11.08.09

In this cohort, there were 167 men and 227 women diagnosed between 1934 and 1984, with a median year of diagnosis of 1975. The median follow-up time for patients who died was 15 years (mean = 15.84 years) and for those still alive is 27 years (mean = 29.19 years), this overall median follow-up is 24 years with a range of 0–58 years (mean = 23.92).

The observed and expected numbers of deaths for men and women in each age group for each quinquenia . The overall SMR for the cohort from 1941 to 2000 was 1.29 (95% CI 1.12–1.45). It was higher in women, 1.43 (95% CI 1.22–1.65) compared with men, 1.13 (95% CI 0.87–1.35) although this difference was not statistically significant . SMR in the total cohort between 1941 and 2000 decreased with age, from 16.95 (95% CI 14.99–18.91) for patients aged 10–19 years, to 0.92 (95% CI 0.65–1.19) in patients aged over 75 years .

The overall SMR for this cohort has decreased over the period of this study, but the change is not statistically significant.

Cox regression was used to analyze trends in mortality according to gender and shows that there is a trend for men with Crohns disease to die younger and live for a shorter period following diagnosis than women. They have a 16% (95% CI −2% to 23%) increased mortality at all ages and survival following diagnosis 16% (95% CI −9% to 21%) shorter than women, but this is not statistically significant (P = 0.15) and is not adjusted to take into account the increased mortality seen in men in the general population.

Life table analysis shows that the life expectancy for men diagnosed with Crohns disease in this cohort is 77.3 years and 79.0 years for women. Overall life expectancy has not statistically significantly changed over the duration of the study and is not statistically significantly different from the life expectancy of the general population (population median over the study period is 71 for males and 77 for females).

However, Kaplan–Meier analysis of age at death of these patients shows that patients diagnosed under 20 years have a median age at death of 64 years (inter-quartile range 59–70 years), whilst those patients diagnosed over the age of 20 years do not experience reduced life expectancy. Some people may also experience fever, mouth ulcers or nausea and vomiting.

People with Crohns disease of the anus can experience pain (especially while passing a bowel motion) or an itch. A few people have disease effecting other parts of the body and may experience swollen joints, inflamed eyes, skin rashes or jaundice (yellow colour of the skin).

The symptoms and their severity vary from person to person and may flare up or improve over time. Many people will experience periods of remission when they are completely free of symptoms. With current medical treatment life expectancy is normal.

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