Kyle Staller1,2, Ola Olén3, Jonas Söderling3,4, Bjorn Roelstraete4, Hans Törnblom5, Hamed Khalili1,2, Amit D Joshi2, Long H Nguyen1,2, Mingyang Song1,2,6, Braden Kuo1, Andrew T Chan1,2, Jonas F Ludvigsson4,7,8,9. 1. Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. 2. Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA. 3. Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden. 4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 5. Institute of Medicine, University of Gothenberg, Gothenberg, Sweden. 6. Departments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 7. Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom. 8. Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA. 9. Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
Abstract
INTRODUCTION: Mortality concern is a frequent driver of care seeking in patients with irritable bowel syndrome (IBS). Data on mortality in IBS are scarce, and population-based studies have been limited in size. We examined mortality in IBS. METHODS: A nationwide, matched, population-based cohort study was conducted in Sweden. We identified 45,524 patients undergoing a colorectal biopsy at any of Sweden's 28 pathology departments and with a diagnosis of IBS from 2002 to 2016 according to the National Patient Register, a nationwide registry of inpatient and outpatient specialty care. We compared the mortality risk between these individuals with IBS and age- and sex-matched reference individuals (n = 217,316) from the general population and siblings (n = 53,228). In separate analyses, we examined the role of mucosal appearance for mortality in IBS. Finally, we examined mortality in 41,427 patients with IBS not undergoing a colorectal biopsy. Cox regression estimated hazard ratios (HRs) for death. RESULTS: During follow-up, there were 3,290 deaths in individuals with IBS (9.4/1,000 person-years) compared with 13,255 deaths in reference individuals (7.9/1,000 person-years), resulting in an HR of 1.10 (95% confidence interval [CI] = 1.05-1.14). After adjustment for confounders, IBS was not linked to mortality (HR = 0.96; 95% CI = 0.92-1.00). The risk estimates were neutral when patients with IBS were compared with their siblings. The underlying mucosal appearance on biopsy had only a marginal impact on mortality, and patients with IBS not undergoing a colorectal biopsy were at no increased risk of death (HR = 1.02; 95% CI = 0.99-1.06). DISCUSSION: IBS does not seem to confer an increased risk of death.
INTRODUCTION: Mortality concern is a frequent driver of care seeking in patients with irritable bowel syndrome (IBS). Data on mortality in IBS are scarce, and population-based studies have been limited in size. We examined mortality in IBS. METHODS: A nationwide, matched, population-based cohort study was conducted in Sweden. We identified 45,524 patients undergoing a colorectal biopsy at any of Sweden's 28 pathology departments and with a diagnosis of IBS from 2002 to 2016 according to the National Patient Register, a nationwide registry of inpatient and outpatient specialty care. We compared the mortality risk between these individuals with IBS and age- and sex-matched reference individuals (n = 217,316) from the general population and siblings (n = 53,228). In separate analyses, we examined the role of mucosal appearance for mortality in IBS. Finally, we examined mortality in 41,427 patients with IBS not undergoing a colorectal biopsy. Cox regression estimated hazard ratios (HRs) for death. RESULTS: During follow-up, there were 3,290 deaths in individuals with IBS (9.4/1,000 person-years) compared with 13,255 deaths in reference individuals (7.9/1,000 person-years), resulting in an HR of 1.10 (95% confidence interval [CI] = 1.05-1.14). After adjustment for confounders, IBS was not linked to mortality (HR = 0.96; 95% CI = 0.92-1.00). The risk estimates were neutral when patients with IBS were compared with their siblings. The underlying mucosal appearance on biopsy had only a marginal impact on mortality, and patients with IBS not undergoing a colorectal biopsy were at no increased risk of death (HR = 1.02; 95% CI = 0.99-1.06). DISCUSSION: IBS does not seem to confer an increased risk of death.
Authors: Jonas F Ludvigsson; Petra Otterblad-Olausson; Birgitta U Pettersson; Anders Ekbom Journal: Eur J Epidemiol Date: 2009-06-06 Impact factor: 8.082
Authors: Kyle Staller; Ola Olén; Jonas Söderling; Bjorn Roelstraete; Hans Törnblom; Hamed Khalili; Mingyang Song; Jonas F Ludvigsson Journal: Eur J Intern Med Date: 2021-08-20 Impact factor: 4.487
Authors: Valeria Castro Tejera; Lena Öhman; Lars Aabakken; Bengt Fellström; Trygve Hausken; Øistein Hovde; Johann P Hreinsson; Greger Lindberg; Per Venge; Magnus Simrén; Hans Törnblom Journal: Aliment Pharmacol Ther Date: 2022-08-08 Impact factor: 9.524