Hospitalized prevalence and 5-year mortality for IBD: Record linkage study

Table 1 Hospitalized prevalence of severe CD and ulcerative colitis across health boards, 1999-2007

Health board	Map1	No. of LSOAs	Deprivation score (mean ± SD)	CD			UC
				Cases	Prevalence (per 100 000)	95% CI	Cases	Prevalence (per 100 000)	95% CI
Blaenau Gwent	1	47	33.8 ± 12.7	31	44.7	(30.4-63.5)	27	39.0	(25.7-56.7)
Bridgend	2	85	23.2 ± 13.0	41	31.5	(22.6-42.7)	62	47.6	(36.5-61.0)
Caerphilly	3	110	27.0 ± 14.1	97	57.0	(46.2-69.5)	91	53.5	(43.0-65.6)
Cardiff	4	203	21.3 ± 18.0	158	50.9	(43.3-59.5)	137	44.1	(37.1-52.2)
Carmarthenshire	5	112	22.0 ± 10.3	125	71.3	(59.3-84.9)	67	38.2	(29.6-48.5)
Ceredigion	6	47	15.0 ± 6.2	35	46.0	(32.0-63.9)	30	39.4	(26.6-56.2)
Conwy	7	71	18.0 ± 11.0	64	57.8	(44.5-73.8)	84	75.9	(60.6-94.0)
Denbighshire	8	58	20.4 ± 15.6	56	59.0	(44.6-76.7)	56	59.0	(44.6-76.7)
Flintshire	9	92	15.0 ± 10.2	74	49.6	(38.9-62.2)	77	51.6	(40.7-64.5)
Gwynedd	10	75	17.3 ± 7.4	63	53.7	(41.2-68.7)	70	59.6	(46.5-75.4)
Isle of Anglesey	11	44	20.7 ± 8.8	43	63.0	(45.6-84.9)	43	63.0	(45.6-84.9)
Merthyr Tydfil	12	36	37.2 ± 17.0	26	46.7	(30.5-68.4)	50	89.7	(66.6-118.3)
Monmouthshire	13	58	12.2 ± 6.0	37	42.9	(30.2-59.1)	44	51.0	(37.1-68.5)
Neath Port Talbot	14	91	28.2 ± 14.4	76	56.0	(44.1-70.0)	53	39.0	(29.2-51.0)
Newport	15	94	22.0 ± 15.6	73	52.4	(41.1-65.9)	71	51.0	(39.8-64.3)
Pembrokeshire	16	71	19.4 ± 8.9	44	38.0	(27.6-51.0)	47	40.6	(29.8-54.0)
Powys	17	80	14.3 ± 6.1	44	34.2	(24.9-46.0)	62	48.2	(37.0-61.8)
Rhondda Cynon Taff	18	152	29.2 ± 15.4	116	50.0	(41.3-60.0)	125	53.9	(44.9-64.2)
Swansea	19	147	22.6 ± 17.8	101	44.9	(36.6-54.6)	109	48.5	(39.8-58.5)
Torfaen	20	60	21.3 ± 10.8	46	50.6	(37.1-67.5)	51	56.1	(41.8-73.8)
Vale of Glamorgan	21	78	15.0 ± 10.5	49	40.7	(30.1-53.7)	74	61.4	(48.2-77.1)
Wrexham	22	85	19.9 ± 13.5	68	52.5	(40.8-66.5)	52	40.2	(30.0-52.6)
All Wales		1896	21.7 ± 14.3	1467	50.1	(47.5-52.7)	1482	50.6	(48.0-53.2)

¹For geographical details of each health board, see Figure 1. CD: Crohn's disease; UC: Ulcerative colitis; LSOA: Lower Super Output Area.

Table 2 Age- and sex-specific hospitalized prevalence rates for severe CD and UC, 1999-2007

		CD			UC
		Cases	Prevalence (per 100 000)	95% CI	Cases	Prevalence (per 100 000)	95% CI
Males	All	601	42.2	(38.9-45.8)	726	51.0	(47.4-54.9)
	0-15	25	8.4	(5.5-12.5)	20	6.7	(4.1-10.4)
	16-29	151	61.4	(52.0-72.0)	115	46.7	(38.6-56.1)
	30-44	141	47.6	(40.1-56.1)	168	56.7	(48.5-66.0)
	45-64	163	44.5	(38.0-51.9)	199	54.4	(47.1-62.5)
	65+	119	54.5	(45.2-65.3)	224	103	(89.7-117)
Females	All	866	57.4	(53.7-61.4)	756	50.1	(46.6-53.8)
	0-15	21	7.5	(4.6-11.4)	11	3.9	(2.0-7.0)
	16-29	185	76.0	(65.5-87.8)	114	46.9	(38.6-56.3)
	30-44	232	74.3	(65.1-84.5)	166	53.2	(45.4-61.9)
	45-64	222	58.9	(51.4-67.2)	189	50.1	(43.3-57.8)
	65+	205	69.4	(60.2-79.6)	276	93.4	(82.7-105)
All Wales		1467	50.1	(47.5-52.7)	1482	50.6	(48.0-53.2)

The ages of three Crohn’s patients, two males and one female, was unknown.

Table 3 Mortality at 1 year following hospitalization for severe CD and UC, 1999-2007

		CD				UC
		Cases	No. of deaths	Mortality rate (%)	Adjusted OR1 (95% CI)	Cases	No. of deaths	Mortality rate (%)	Adjusted OR1(95% CI)
All		1261	86	6.8		1300	119	9.2
Age groups by gender
Male	All	506	30	5.9		633	50	7.9
	0-15	22	0	0.0		16	0	0.0
	16-29	128	0	0.0		101	0	0.0
	30-44	119	1	0.8		145	0	0.0
	45-64	136	5	3.7		172	7	4.1
	65+	99	24	24.2		199	43	21.6
Female	All	755	56	7.4		667	69	10.3
	0-15	19	0	0.0		8	0	0.0
	16-29	165	2	1.2		96	0	0.0
	30-44	202	5	2.5		151	3	2.0
	45-64	189	7	3.7		169	8	4.7
	65+	179	42	23.5		243	58	23.9
Sex
Male		504	30	6.0	Ref.	633	50	7.9	Ref.
Female		754	56	7.4	1.05 (0.63-1.74)	667	69	10.3	1.03 (0.67-1.57)
Colectomy performed
Yes		193	9	4.7	Ref.	162	17	10.5	Ref.
No		1068	77	7.2	1.59 (0.74-3.41)	1138	102	9.0	0.57 (0.31-1.05)
Social deprivation
I (least deprived)		229	16	7.0	0.99 (0.45-2.17)	234	20	8.5	0.83 (0.42-1.65)
II		236	10	4.2	0.49 (0.21-1.18)	245	21	8.6	0.89 (0.45-1.76)
III		257	23	8.9	1.23 (0.60-2.55)	282	27	9.6	0.86 (0.46-1.61)
IV		277	20	7.2	0.85 (0.41-1.77)	280	27	9.6	0.99 (0.52-1.86)
V (most deprived)		262	17	6.5	Ref.	259	24	9.3	Ref.
Urban/rural residence
Under 2500 people		256	17	6.6	Ref.	277	22	7.9	Ref.
2500-9999		205	13	6.3	0.76 (0.33-1.76)	222	21	9.5	1.29 (0.64-2.59)
10 000-24 999		278	26	9.4	1.48 (0.72-3.06)	280	24	8.6	1.17 (0.60-2.30)
25 000-99 999		260	15	5.8	0.71 (0.32-1.60)	274	28	10.2	1.48 (0.77-2.85)
At least 100 000		262	15	5.7	0.67 (0.29-1.54)	247	24	9.7	1.58 (0.80-3.14)
Distance from hospital
< 3 km		187	14	7.5	Ref.	211	21	10.0	Ref.
3-4.99 km		145	6	4.1	0.55 (0.19-1.59)	159	14	8.8	0.97 (0.44-2.10)
5-9.99 km		269	18	6.7	1.03 (0.46-2.31)	285	25	8.8	0.91 (0.47-1.76)
10-19.99 km		318	22	6.9	1.14 (0.52-2.49)	303	30	9.9	0.94 (0.49-1.80)
≥ 20 km		207	16	7.7	1.14 (0.49-2.65)	206	19	9.2	1.03 (0.50-2.13)

¹The OR for sex is adjusted for age group. The OR for social deprivation and colectomy was adjusted for age group and sex. The adjusted OR for urban/rural residence and distance from hospital was adjusted for age group, sex and social deprivation.

Table 4 Mortality at 5 years following hospitalization for severe Crohn’s disease and ulcerative colitis, 1999-2007

		CD				UC
		Cases2	No. of deaths	Mortality rate (%)	Adjusted OR1 (95% CI)	Cases2	No. of deaths	Mortality rate (%)	Adjusted OR1(95% CI)
All		535	78	14.6		567	118	20.8
Age groups by sex
Male	All	209	28	13.4		275	55	20.0
	0-15	10	0	0.0		5	0	0.0
	16-29	50	0	0.0		43	1	2.3
	30-44	52	2	3.8		73	0	0.0
	45-64	58	8	13.8		63	4	6.3
	65+	39	18	46.2		91	50	54.9
Female	All	326	50	15.3		292	63	21.6
	0-15	9	0	0.0		4	0	0.0
	16-29	72	1	1.4		40	1	2.5
	30-44	91	3	3.3		59	2	3.4
	45-64	84	10	11.9		86	6	7.0
	65+	70	36	51.4		103	54	52.4
Sex
Male		209	28	13.4	Ref.	275	55	20.0	Ref.
Female		326	50	15.3	0.96 (0.52-1.76)	292	63	21.6	0.76 (0.44-1.31)
Colectomy performed
Yes		89	10	11.2	Ref.	72	15	20.8	Ref.
No		446	68	15.2	1.48 (0.63-3.52)	495	103	20.8	0.59 (0.26-1.33)
Social deprivation
I (least deprived)		110	14	12.7	0.53 (0.20-1.39)	110	24	21.8	1.39 (0.61-3.19)
II		102	9	8.8	a0.23 (0.08-0.68)	110	19	17.3	0.85 (0.35-2.05)
III		112	16	14.3	0.56 (0.21-1.46)	114	31	27.2	1.62 (0.73-3.58)
IV		106	21	19.8	1.09 (0.45-2.68)	112	23	20.5	1.29 (0.55-3.02)
V (most deprived)		105	18	17.1	Ref.	121	21	17.4	Ref.
Urban/rural residence
Under 2500 people		103	11	10.7	Ref.	124	28	22.6	Ref.
2500-9999		89	16	18.0	1.42 (0.49-4.12)	105	22	21.0	0.64 (0.26-1.53)
10 000-24 999		124	21	16.9	1.32 (0.49-3.56)	109	18	16.5	0.47 (0.19-1.17)
25 000-99 999		99	15	15.2	0.75 (0.26-2.14)	121	26	21.5	0.86 (0.37-1.97)
≥ 100 000		120	15	12.5	0.89 (0.31-2.54)	108	24	22.2	0.84 (0.35-1.98)
Distance from hospital
< 3 km		87	14	16.1	Ref.	101	24	23.8	Ref.
3-4.99 km		73	9	12.3	0.52 (0.16-1.63)	67	14	20.9	0.80 (0.31-2.09)
5-9.99 km		111	12	10.8	0.71 (0.25-2.01)	123	22	17.9	0.80 (0.35-1.85)
10-19.99 km		135	17	12.6	0.81 (0.30-2.19)	112	27	24.1	0.97 (0.41-2.29)
≥ 20 km		70	15	21.4	1.26 (0.42-3.78)	87	16	18.4	0.78 (0.31-2.00)

^aP < 0.01. ¹The OR for sex was adjusted for age group. The OR for social deprivation and colectomy was adjusted for age group and sex. The adjusted OR for urban/rural residence and distance from hospital was adjusted for age group, sex and social deprivation; ²Fewer people had 5 years than 1 year follow-up during the 9-year study period, therefore, the number of cases was lower in this Table than in Table 3.