In:
Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 15, No. 3 ( 2021-03-05), p. 401-408
Kurzfassung:
Elderly-onset inflammatory bowel disease [IBD], defined as age ≥60 at diagnosis, is increasing worldwide. We aimed to compare clinical characteristics and natural history of elderly-onset IBD patients with those of adult-onset IBD patients. Methods Patients with a confirmed diagnosis of IBD from 1981 to 2016 were identified from a territory-wide Hong Kong IBD registry involving 13 hospitals. Demographics, comorbidities, clinical features, and outcomes of elderly-onset IBD patients were compared with those of adult-onset IBD patients. Results A total of 2413 patients were identified, of whom 270 [11.2%] had elderly-onset IBD. Median follow-up duration was 111 months (interquartile range [IQR] : 68–165 months). Ratio of ulcerative colitis [UC]: Crohn’s disease [CD] was higher in elderly-onset IBD than in adult-onset IBD patients [3.82:1 vs 1.39:1; p & lt;0.001]. Elderly-onset CD had less perianal involvement [5.4% vs 25.4%; p & lt;0.001] than adult-onset CD. Elderly-onset IBD patients had significantly lower cumulative use of immunomodulators [p = 0.001] and biologics [p = 0.04]. Elderly-onset IBD was associated with higher risks of: cytomegalovirus colitis (odds ratio [OR] : 3.07; 95% confidence interval [CI] 1.92–4.89; p & lt;0.001); herpes zoster [OR: 2.42; 95% CI 1.22–4.80; p = 0.12]; and all cancer development [hazard ratio: 2.97; 95% CI 1.84–4.79; p & lt;0.001]. They also had increased number of overall hospitalisations [OR: 1.14; 95% CI 1.09–1.20; p & lt;0.001], infections-related hospitalisation [OR: 1.87; 95% CI 1.47–2.38; p & lt;0.001], and IBD-related hospitalisation [OR: 1.09; 95% CI 1.04- 1.15; p = 0.001] compared with adult-onset IBD patients. Conclusions Elderly-onset IBD was associated with increased risk of infections and cancer development, and increased infection- and IBD-related hospitalisations. Specific therapeutic strategies to target this special population are needed.
Materialart:
Online-Ressource
ISSN:
1873-9946
,
1876-4479
DOI:
10.1093/ecco-jcc/jjaa181
Sprache:
Englisch
Verlag:
Oxford University Press (OUP)
Publikationsdatum:
2021
ZDB Id:
2389631-0
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