Epidemiology and Natural History of Elderly-onset Inflammatory Bowel Disease: Results From a Territory-wide Hong Kong IBD Registry.

Autor: Mak JWY; Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong., Lok Tung Ho C; Imperial College School of Medicine, London, UK., Wong K; Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong., Cheng TY; Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong., Yip TCF; Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong., Leung WK; Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong., Li M; Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong., Lo FH; Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong., Ng KM; Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong., Sze SF; Department of Medicine, Queen Elizabeth Hospital, Hong Kong., Leung CM; Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong., Tsang SWC; Department of Medicine, Tseung Kwan O Hospital, Hong Kong., Shan EHS; Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong., Chan KH; Department of Medicine, North District Hospital, Hong Kong., Lam BCY; Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong., Hui AJ; Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong., Chow WH; Department of Medicine, Yan Chai Hospital, Hong Kong., Ng SC; Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong.
Jazyk: angličtina
Zdroj: Journal of Crohn's & colitis [J Crohns Colitis] 2021 Mar 05; Vol. 15 (3), pp. 401-408.
DOI: 10.1093/ecco-jcc/jjaa181
Abstrakt: Background: 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 <0.001]. Elderly-onset CD had less perianal involvement [5.4% vs 25.4%; p <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 <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 <0.001]. They also had increased number of overall hospitalisations [OR: 1.14; 95% CI 1.09-1.20; p <0.001], infections-related hospitalisation [OR: 1.87; 95% CI 1.47-2.38; p <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.
(© The Author(s) 2020. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze: MEDLINE
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