Agrawal, A.; Kennedy, S.; Morris, A.I.; Ellis, A.; Leiper, K.; Rhodes, J.M.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA67
Academic Journal
Introduction: It is recognised that life expectancy in Crohn's disease is sJightly reduced (Jess et al, Gastroenterology 2002;'122:1808) but few studies have addressed causes of mortality. Methods: All patients attending our centre have been logged onto a centralised database since 1996. This includes 676 patients with Crohn's disease with a median age of 43 years, range 17-93 years. During the study period (Jan 1996-June 2002) 32 of these patients died with a median age of 57, range 18-89. Case notes were available for 30 of these patients but contained incomplete data in 4; the remaining 26 were analysed with regards to cause of death. Results: Eleven (42%) of the deaths were attributable to Crohn's disease. Apart from post-operative deaths and Crohn's related malignancy (small intestinal cancer 1, rectal cancer 1, rectal lymphoma 1) these included amyloidosis and renal failure (1), sepsis (2), right atrial thrombus complicating TPN (1) and malnutrition in an elderly patient (1). The median age for those whose death was related to Crohn's disease was 48 years (range 36-83) and for those that died of other causes was 72.5 years (range 32-89). All 8 non-malignant Crohn's related deaths were in patients receiving systemic corticosteroids compared to 39% of those who died of other causes. Seven (64%) patients who died of Crohn's disease were smokers at the time of death compared to 40% of those who died due to unrelated causes. Conclusion: Crohn's disease is still associated with a considerable mortality. Further study is justified to assess whether use of systemic corticosteroids may contribute to this mortality.


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