New Research Quantifies Life Expectancy for IBD Patients

Author(s):

Life expectancy rates were lower in patients with IBD when compared to a healthy control group.

M. Ellen Kuenzig, PhD

While inflammatory bowel disease (IBD) such as Crohn's disease, can be fatal, it is not entirely known what the life expectancy is for patients who contract the disease.

A team, led by M. Ellen Kuenzig, PhD, Division of Gastroenterology, Hepatology and Nutrition (Benchimol), The Hospital for Sick Children, determined trends in life expectancy and health-adjusted life expectancy in patients with and without IBD.

In the retrospective cohort study, the investigators used population-level health administrative, demographic, and health survey data available from databases in Ontario. The research team then matched patients with a diagnosis of IBD with a healthy control group and used period life table generated with age- and sex-specific five-year mortality rates to calculate life expectancy for 1996, 2000, 2008, and 2011.

The investigators also incorporated the Health Utility Index (National Population Health Study; Canadian Community Health Survey) to estimate health-adjusted life expectancy for 1996, 2000, and 2008.

Overall, the data shows the life expectancy of IBD patients increased between 1996-2011 (females: 75.5 -78.4 years; difference, 2.9 years; 95% CI, 1.3-4.5; males: 72.2-75.5 years; difference, 3.2 years; 95% CI, 2.1-4.4).

They also found the health-adjusted life expectancy decreased among males by 3.9 years (95% CI, 1.2-6.6) between 1996-2008.

However, there was no statistically significant change found in health-adjusted life expectancy among females width IBD (difference, 2.0 years; 95% CI, -1.6 to 5.7).

The life-expectancy and health-adjusted life expectancy was also lower in patients with IBD when compared to the healthy control group.

The differences in life expectancy differences for both arms of the study ranged from 6.6-8.1 years in females and 5.0-6.1 years in males, depending on the year.

Differences in health-adjusted life expectancy for both groups ranged from 9.5-13.5 years in females and 2.6-6.7 years in males.

“Whilst life expectancy has increased among people with IBD, a gap in life expectancy between those with and without IBD remains, and the effect of pain on daily functioning contributes substantially to reduced health-adjusted life expectancy, suggesting that improved pain mitigation strategies should be implemented,” the authors wrote.

In recent years, the management of IBD has improved through increased access to specialist care, as well as the increased prevalence of biologic therapies and treat-to-target approaches involving treatment aimed at minimizing inflammation and preventing disease progression.

While biologics improve the quality of life for patients, they may also increase the risk of serious infections and malignant disease, especially for older patients. Changes to IBD management and medication could be impacting life expectancy and quality of life.

Researchers have also found in recent years that the mortality rate is higher in patients with Crohn’s disease when compared to the general population. However, studies evaluating mortality rates in ulcerative colitis have not been conclusive.

In addition, the majority of studies evaluating the mortality rate for IBD patients were conducted prior to the biologic era, while none evaluated life expectancy or health-adjusted life expectancy.

The study, “Life expectancy and health-adjusted life expectancy in people with inflammatory bowel disease,” was published online in CMAJ (Canadian Medical Association Journal).

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