P0568 Mortality and comorbidities in people with Inflammatory Bowel Disease - Crohn’s Colitis Cure data insights program
Authors: Alsulaibi O , Su W K , Wilson W , Sin L , Ng W , Walker G , Forbes A , Lawrance I , Lynch K , Begun J , Connor S J , Andrews J M 
Published: January 2025

Background

The prevalence of Inflammatory Bowel Disease (IBD) has increased worldwide with Australia and New Zealand amongst the highest prevalence rates. Older literature suggested that people with IBD experienced higher mortality rates than the general population1. Conversely, in other studies, IBD patient survival has been shown to be similar to that of the general population2, 3. As these results are discrepant and data possibly outdated, we explored comorbidities and demography of people with IBD receiving care in Australasian centres using Crohn’s Colitis Care (CCCare).

Methods

CCCare is an IBD-specific cloud-based EMR used in Australasia. Data feed into a de-identified clinical quality registry (CQR), which was interrogated in September 2024. People with IBD who have ever been clinically assessed since August 2018 were included.

Results

Of the 9050 eligible people, 0.7% (n=61) are documented as deceased, with comparative demographics presented in table 1. Comparing the deceased cohort with the non-deceased, there were a significant difference in median age (73 years vs 41 years, p&lt;0.001) and disease duration (20.5 years vs 10.8 years, p&lt;0.001). In those deceased, a higher proportion of people had Crohn’s disease (70.5%, n=43) compared to the non-deceased cohort. Over half those deceased were aged between 70 – 89 years (52.5%, n=32). There was no difference between groups in gender, country of residence, steroid use, immunomodulator use or the rate of combined endoscopic and radiological remission. The deceased were more likely to be receiving an advanced therapy at their last assessment (65.6%, n=40 vs 51.6%, n=4636, p&lt;0.05). Hypertension was the most common comorbidity in both groups (17.2%, n=10 vs 9.0%, n=518, p&lt;0.05). Amongst people with IBD who were deceased, ischaemic heart disease (15.5%, n=9), Type 2 diabetes mellitus (13.8%, n=8), and asthma (10.3%, n=6) were the most common comorbidities. Most of the deceased cohort were active or previous smokers (54.1%, n=33 vs 27.3%, n=2455, p&lt;0.001).

Conclusion

Although the median age of death amongst people with IBD in CCCare is lower than the median age of 82 in the general Australian population, the most frequently documented comorbidities in this group are reflective of the chronic diseases associated with known causes of death. The deceased cohort were more likely to be active or previous smokers, highlighting the necessity of smoking cessation to improve mortality rates and IBD outcomes. Initial data suggests IBD is less likely to be a life-limiting condition, and further analysis is required to characterise contributors to mortality in IBD. As this dataset grows it will enable better tracking of IBD survival to guide patient care.

References

1.Persson, P. et al. (1996) ‘Survival and cause-specific mortality in inflammatory bowel disease: A population-based Cohort Study’, Gastroenterology, 110(5), pp. 1339–1345.

2.Andrews, J.M. et al. (1995) ‘Inflammatory bowel disease: A retrospective review of a specialist-based cohort’, Medical Journal of Australia, 163(3), pp. 133–136.

3.Selinger, C.P. et al. (2013) ‘Cause-specific mortality and 30-year relative survival of crohnʼs disease and ulcerative colitis’, Inflammatory Bowel Diseases, 19(9), pp. 1880-1888.