Åsa H Everhov1,2, Michael C Sachs3, Petter Malmborg1,2, Caroline Nordenvall4,5, Pär Myrelid6,7, Hamed Khalili2,8, Maria Elmberg2, Anders Ekbom2, Johan Askling2, Gustav Jakobsson9, Jonas Halfvarson10, Jonas F Ludvigsson9,10,11,12,13, Ola Olén1,2,14. 1. a Department of Clinical Science and Education , Södersjukhuset, Karolinska Institutet , Stockholm , Sweden. 2. b Clinical Epidemiology Unit, Department of Medicine Solna , Karolinska Institutet , Stockholm , Sweden. 3. c Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden. 4. d Department of Molecular Medicine and Surgery , Karolinska Institutet , Stockholm , Sweden. 5. e Center for Digestive Disease, Div. of Coloproctology , Karolinska University Hospital , Stockholm , Sweden. 6. f Division of Surgery, Department of Clinical and Experimental Medicine , Faulty of Health Sciences , Linköping, Sweden. 7. g University and Department of Surgery , County Council of Östergötland Linköping , Linköping, Sweden. 8. h Gastroenterology Unit, Crohn's and Colitis Center, Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA. 9. i Department Medical Epidemiology and Biostatistics , Karolinska Institutet , Stockholm , Sweden. 10. j Department of Gastroenterology, Faculty of Medicine and Health , Örebro University , Örebro , Sweden. 11. k Department of Pediatrics , Örebro University Hospital, Örebro University , Örebro , Sweden. 12. l Division of Epidemiology and Public Health , School of Medicine, University of Nottingham , Nottingham , UK. 13. m Department of Medicine , Columbia University College of Physicians and Surgeons , New York , NY , USA. 14. n Department of pediatric gastroenterology and nutrition , Sachs' Children and Youth Hospital , Stockholm , Sweden.
Abstract
AIM: To investigate inflammatory bowel disease (IBD) register-based subtype classifications over a patient's disease course and over time. METHODS: We examined International Classification of Diseases coding in patients with ≥2 IBD diagnostic listings in the National Patient Register 2002-2014 (n = 44,302). RESULTS: 18% of the patients changed diagnosis (17% of adults, 29% of children) during a median follow-up of 3.8 years. Of visits with diagnoses of Crohn's disease (CD) or ulcerative colitis (UC), 97% were followed by the same diagnosis, whereas 67% of visits with diagnosis IBD-unclassified (IBD-U) were followed by another IBD-U diagnosis. Patients with any diagnostic change changed mostly once (47%) or twice (31%), 39% from UC to CD, 33% from CD to UC and 30% to or from IBD-U. Using a classification algorithm based on the first two diagnoses ('incident classification'), suited for prospective cohort studies, the proportion adult patients with CD, UC, and IBD-U 2002-2014 were 29%, 62%, and 10% (43%, 45%, and 12% in children). A classification model incorporating additional information from surgeries and giving weight to the last 5 years of visits ('prevalent classification'), suited for description of a study population at end of follow-up, classified 31% of adult cases as CD, 58% as UC and 11% as IBD-U (44%, 38%, and 18% in children). CONCLUSIONS: IBD subtype changed in 18% during follow-up. The proportion with CD increased and UC decreased from definition at start to end of follow-up. IBD-U was more common in children.
AIM: To investigate inflammatory bowel disease (IBD) register-based subtype classifications over a patient's disease course and over time. METHODS: We examined International Classification of Diseases coding in patients with ≥2 IBD diagnostic listings in the National Patient Register 2002-2014 (n = 44,302). RESULTS: 18% of the patients changed diagnosis (17% of adults, 29% of children) during a median follow-up of 3.8 years. Of visits with diagnoses of Crohn's disease (CD) or ulcerative colitis (UC), 97% were followed by the same diagnosis, whereas 67% of visits with diagnosis IBD-unclassified (IBD-U) were followed by another IBD-U diagnosis. Patients with any diagnostic change changed mostly once (47%) or twice (31%), 39% from UC to CD, 33% from CD to UC and 30% to or from IBD-U. Using a classification algorithm based on the first two diagnoses ('incident classification'), suited for prospective cohort studies, the proportion adult patients with CD, UC, and IBD-U 2002-2014 were 29%, 62%, and 10% (43%, 45%, and 12% in children). A classification model incorporating additional information from surgeries and giving weight to the last 5 years of visits ('prevalent classification'), suited for description of a study population at end of follow-up, classified 31% of adult cases as CD, 58% as UC and 11% as IBD-U (44%, 38%, and 18% in children). CONCLUSIONS: IBD subtype changed in 18% during follow-up. The proportion with CD increased and UC decreased from definition at start to end of follow-up. IBD-U was more common in children.
Authors: Sara Rundquist; Michael C Sachs; Carl Eriksson; Ola Olén; Scott Montgomery; Jonas Halfvarson Journal: Aliment Pharmacol Ther Date: 2020-12-19 Impact factor: 8.171
Authors: Åsa H Everhov; Thordis Disa Kalman; Jonas Söderling; Caroline Nordenvall; Jonas Halfvarson; Anders Ekbom; Jonas F Ludvigsson; Ola Olén; Pär Myrelid Journal: Inflamm Bowel Dis Date: 2022-08-01 Impact factor: 7.290
Authors: Petter Malmborg; Åsa H Everhov; Jonas Söderling; Jonas F Ludvigsson; Gustaf Bruze; Ola Olén Journal: Aliment Pharmacol Ther Date: 2022-08-02 Impact factor: 9.524
Authors: Åsa H Everhov; Rune Erichsen; Jacob Järås; Lars Pedersen; Jonas Halfvarson; Johan Askling; Anders Ekbom; Jonas F Ludvigsson; Henrik Toft Sørensen; Ola Olén Journal: Aliment Pharmacol Ther Date: 2022-08-02 Impact factor: 9.524
Authors: Åsa H Everhov; Michael C Sachs; Jonas F Ludvigsson; Hamed Khalili; Johan Askling; Martin Neovius; Pär Myrelid; Jonas Halfvarson; Caroline Nordenvall; Jonas Söderling; Ola Olén Journal: Clin Epidemiol Date: 2020-03-10 Impact factor: 4.790
Authors: Åsa H Everhov; Gustaf Bruze; Jonas Söderling; Johan Askling; Jonas Halfvarson; Karin Westberg; Petter Malmborg; Caroline Nordenvall; Jonas F Ludvigsson; Ola Olén Journal: J Crohns Colitis Date: 2021-06-22 Impact factor: 9.071