Background & Aims

Microscopic colitis is one of the most common causes of chronic diarrhea in older populations. We investigated all-cause and cause-specific mortality in patients with microscopic colitis.

Methods

We conducted a nationwide cohort study of all cases of microscopic colitis (n = 14,333) diagnosed from 1990 through 2017 in Sweden. Cases of microscopic colitis were identified using SNOMED codes from gastrointestinal histopathology reports collected from Sweden’s 28 pathology departments. Each case of microscopic colitis was matched to 5 population comparators (n = 68,700). Mortality data were ascertained from Sweden’s cause of death register. We used Cox proportional hazards modeling to estimate adjusted hazard ratios (aHRs) and 95% CIs.

Results

Through December of 2017, we confirmed 3014 deaths in patients with microscopic colitis (27.4/1000 person-years) and 12,534 deaths in matched population comparators (23.3/1000 person-years). This corresponded to a 10-year absolute risk difference of 3.4% (95% CI, 2.1%–4.6%) and an aHR of 1.17 (95% CI, 1.12–1.22). However, further adjustment of models for comorbidity burden reduced the relative risk of death for patients with microscopic colitis (aHR, 0.98; 95% CI, 0.94–1.02). In analyses of cause-specific death, microscopic colitis was associated with an increased risk of gastrointestinal-related death (aHR, 1.68; 95% CI, 1.38–2.05) and infection-related death (aHR, 1.42 ; 95% CI, 1.11–1.83), but not cancer-related death (aHR, 0.83; 95% CI, 0.76–0.91) or cardiovascular-related death (aHR, 1.02; 95% CI, 0.96–1.10).

Conclusions

In a nationwide cohort study in Sweden, we found that patients with microscopic colitis were at increased risk of death. However, the increase appears to be related to higher burden of comorbidities in this population.

中文翻译：

---

瑞典显微镜下结肠炎患者的死亡率。

背景与目标

显微镜下结肠炎是老年人群慢性腹泻的最常见原因之一。我们调查了显微镜下结肠炎患者的全因和特定原因死亡率。

方法

我们对 1990 年至 2017 年在瑞典诊断出的所有显微镜下结肠炎病​​例（n = 14,333）进行了一项全国性队列研究。使用从瑞典 28 个病理科室收集的胃肠道组织病理学报告中的 SNOMED 代码识别显微镜下结肠炎病​​例。每个显微镜结肠炎病例都与 5 个人群比较对象（n = 68,700）相匹配。死亡率数据来自瑞典的死因登记册。我们使用 Cox 比例风险模型来估计调整后的风险比 (aHR) 和 95% CI。

结果

到 2017 年 12 月，我们确认了 3014 例显微镜下结肠炎患者的死亡（27.4/1000 人年）和 12534 例匹配人群对照者的死亡（23.3/1000 人年）。这对应于 3.4%（95% CI，2.1%–4.6%）的 10 年绝对风险差异和 1.17（95% CI，1.12–1.22）的 aHR。然而，对合并症负担模型的进一步调整降低了显微镜下结肠炎患者的相对死亡风险（aHR，0.98；95% CI，0.94–1.02）。在对特定原因死亡的分析中，显微镜下结肠炎与胃肠道相关死亡（aHR，1.68；95% CI，1.38-2.05）和感染相关死亡（aHR，1.42；95% CI，1.11-）的风险增加有关1.83)，但不是癌症相关死亡 (aHR, 0.83; 95% CI, 0.76–0.91) 或心血管相关死亡 (aHR, 1.02; 95% CI, 0.96–1.10)。

结论

在瑞典的一项全国性队列研究中，我们发现显微镜下结肠炎患者的死亡风险增加。然而，增加似乎与该人群中更高的合并症负担有关。