Objectives To examine all-cause and cause-specific mortality in adult-onset and elderly-onset IBD and to describe time trends in mortality over the past 50 years. Design Swedish nationwide register-based cohort study 1964–2014, comparing mortality in 82 718 incident IBD cases (inpatient and non-primary outpatient care) with 10 times as many matched general population reference individuals (n=801 180) using multivariable Cox regression to estimate HRs. Among patients with IBD, the number of participants with elderly-onset (≥60 years) IBD was 17 873. Results During 984 330 person-years of follow-up, 15 698/82 718 (19%) of all patients with IBD died (15.9/1000 person-years) compared with 121 095/801 180 (15.1%) of reference individuals, corresponding to an HR of 1.5 for IBD (95% CI=1.5 to 1.5 (HR=1.5; 95% CI=1.5 to 1.5 in elderly-onset IBD)) or one extra death each year per 263 patients. Mortality was increased specifically for UC (HR=1.4; 95% CI=1.4 to 1.5), Crohn’s disease (HR=1.6; 95% CI=1.6 to 1.7) and IBD-unclasssified (HR=1.6; 95% CI=1.5 to 1.8). IBD was linked to increased rates of multiple causes of death, including cardiovascular disease (HR=1.3; 1.3 to 1.3), malignancy (HR=1.4; 1.4 to 1.5) and digestive disease (HR=5.2; 95% CI=4.9 to 5.5). Relative mortality during the first 5 years of follow-up decreased significantly over time. Incident cases of 2002–2014 had 2.3 years shorter mean estimated life span than matched comparators. Conclusions Adult-onset and elderly-onset patients with UC, Crohn’s disease and IBD-unclassified were all at increased risk of death. The increased mortality remained also after the introduction of biological therapies but has decreased over time.

中文翻译：

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成人发病和老年发病 IBD 的死亡率：1964-2014 年基于全国登记的队列研究

目的 研究成人发病和老年发病的 IBD 的全因死亡率和病因特异性死亡率，并描述过去 50 年死亡率的时间趋势。1964 年至 2014 年设计瑞典全国基于登记册的队列研究，使用多变量 Cox 回归将 82 718 例 IBD 事件（住院和非初级门诊）的死亡率与匹配的普通人群参考个体（n = 801 180）的 10 倍进行比较估计 HR。在 IBD 患者中，老年（≥60 岁）IBD 参与者人数为 17 873。 结果 在 984 330 人年的随访期间，所有 IBD 患者中有 15 698/82 718（19%）死亡(15.9/1000 人年) 与 121 095/801 180 (15.1%) 的参考个体相比，对应于 IBD 的 HR 为 1.5（95% CI=1.5 到 1.5（HR=1.5；95% CI=1.5 到1. 5 例老年人发病的 IBD)) 或每年每 263 名患者额外死亡 1 例。UC（HR=1.4；95% CI=1.4 至 1.5）、克罗恩病（HR=1.6；95% CI=1.6 至 1.7）和 IBD 未分类（HR=1.6；95% CI=1.5 至 1.5 至1.8）。IBD 与多种死因的发生率增加有关，包括心血管疾病（HR=1.3；1.3 至 1.3）、恶性肿瘤（HR=1.4；1.4 至 1.5）和消化系统疾病（HR=5.2；95% CI=4.9 至 5.5） ）。随着时间的推移，前 5 年随访期间的相对死亡率显着下降。2002-2014 年的事故案例比匹配的比较者的平均估计寿命短 2.3 年。结论 患有 UC、克罗恩病和 IBD 未分类的成人和老年起病患者的死亡风险均增加。