Crohn's Disease - Overall survival may be reduced
Clinical Bottom Line
Overall survival for Crohn's disease patients is 92% of that expected but only for patients diagnosed before 1974.
Citation
Loftus EV, Silverstein MD, Sandborn WJ, et al. Crohn's Disease in Olmstead County Minnesota, 1940-1993: Incidence, Prevalence, and Survival. Gastroenterology 1998;114:1161-1168.
Clinical Question
In a patient with newly diagnosed Crohn's disease what are the chances of dying prematurely?
Search Terms
"crohn's disease" and "survival" in Medline
The Study
- 226 pts registered in a community-based Crohn's registry and followed prospectively for median of 13.4 years (range, 0.3-51.3) after diagnosis.
- The Outcome: death
- Well-defined sample at uniform (early) stage of illness? yes;
- Follow-up long enough? yes;
- Follow-up complete? reasonably (20% drop out);
- Blind and objective outcome criteria? yes;
- Adjustment for other prognostic factors? no;
- Validation in an independent "test-set" of patients? no
The Evidence
| Prognostic Factor | Outcome | Time | Measure | Confidence Interval |
|---|---|---|---|---|
| Crohn's disease | Death | 13.4 years | 19% | 13.9% to 24.1% |
Comments
- Decreased survival only applies to patients diagnosed before 1974
- 90% of Olmstead population included
- Rely on diagnosis of Crohn's
- 20% lost in follow-up
- US study ? applicable worldwide?
- Small numbers in more recent decennial cohorts
Appraised By
W. Rosenberg, 1999
Expiry Date
2000