Original Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 28, 2010; 16(4): 431-438
Published online Jan 28, 2010. doi: 10.3748/wjg.v16.i4.431
Hospitalized prevalence and 5-year mortality for IBD: Record linkage study
Lori A Button, Stephen E Roberts, Michael J Goldacre, Ashley Akbari, Sarah E Rodgers, John G Williams
Lori A Button, Stephen E Roberts, Ashley Akbari, Sarah E Rodgers, John G Williams, School of Medicine, Swansea University, Swansea SA2 8PP, United Kingdom
Michael J Goldacre, Unit of Health-Care Epidemiology, University of Oxford, Oxford OX2 7LF, United Kingdom
Author contributions: Roberts SE initiated the study; Roberts SE, Williams JG and Goldacre MJ designed the study; Roberts SE and Button LA reviewed the literature; Button LA and Akbari A undertook the analyses; Rodgers SE undertook the GIS analyses; Roberts SE, Button LA, Goldacre MJ and Williams JG interpreted the study findings and wrote the manuscript.
Supported by The Health Foundation
Correspondence to: Dr. Stephen E Roberts, School of Medicine, Swansea University, Singleton Park, Swansea, SA2 8PP, United Kingdom. stephen.e.roberts@swansea.ac.uk
Telephone: +44-1792-513426 Fax: +44-1792-513423
Received: August 24, 2009
Revised: October 17, 2009
Accepted: October 24, 2009
Published online: January 28, 2010
Abstract

AIM: To establish the hospitalized prevalence of severe Crohn’s disease (CD) and ulcerative colitis (UC) in Wales from 1999 to 2007; and to investigate long-term mortality after hospitalization and associations with social deprivation and other socio-demographic factors.

METHODS: Record linkage of administrative inpatient and mortality data for 1467 and 1482 people hospitalised as emergencies for ≥ 3 d for CD and UC, respectively. The main outcome measures were hospitalized prevalence, mortality rates and standardized mortality ratios for up to 5 years follow-up after hospitalization.

RESULTS: Hospitalized prevalence was 50.1 per 100 000 population for CD and 50.6 for UC. The hospitalized prevalence of CD was significantly higher (P < 0.05) in females (57.4) than in males (42.2), and was highest in people aged 16-29 years, but the prevalence of UC was similar in males (51.0) and females (50.1), and increased continuously with age. The hospitalized prevalence of CD was slightly higher in the most deprived areas, but there was no association between social deprivation and hospitalized prevalence of UC. Mortality was 6.8% and 14.6% after 1 and 5 years follow-up for CD, and 9.2% and 20.8% after 1 and 5 years for UC. For both CD and UC, there was little discernible association between mortality and social deprivation, distance from hospital, urban/rural residence and geography.

CONCLUSION: CD and UC have distinct demographic profiles. The higher prevalence of hospitalized CD in more deprived areas may reflect higher prevalence and higher hospital dependency.

Keywords: Crohn’s disease, Ulcerative colitis, Prevalence, Mortality, Record linkage