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Adult-onset inflammatory bowel disease and rate of serious infections compared to the general population : a nationwide register-based cohort study 2002–2017

Ludvigsson, Jonas F. ; Holmgren, Johanna LU ; Grip, Olof LU ; Halfvarson, Jonas ; Askling, Johan ; Sachs, Michael C. and Olén, Ola (2021) In Scandinavian Journal of Gastroenterology 56(10). p.1152-1162
Abstract

Objectives: To investigate absolute and relative risk of serious infections in adult/elderly inflammatory bowel disease (IBD) diagnosed 2002–2017. Methods: Nationwide, register-based cohort study of Swedish patients with IBD compared with general population matched reference individuals with regard to time to first serious infection, equal to hospital admission. Multivariable Cox regression estimated hazard ratios (HRs) for any serious infection. Secondary outcomes included site-specific infections, opportunistic infections and sepsis. Results: We identified 47 798 individuals with IBD. During a follow-up of 329 000 person-years, they had 8752 first serious infections (26.6 per 1000 person-years). This compared with an incidence rate of... (More)

Objectives: To investigate absolute and relative risk of serious infections in adult/elderly inflammatory bowel disease (IBD) diagnosed 2002–2017. Methods: Nationwide, register-based cohort study of Swedish patients with IBD compared with general population matched reference individuals with regard to time to first serious infection, equal to hospital admission. Multivariable Cox regression estimated hazard ratios (HRs) for any serious infection. Secondary outcomes included site-specific infections, opportunistic infections and sepsis. Results: We identified 47 798 individuals with IBD. During a follow-up of 329 000 person-years, they had 8752 first serious infections (26.6 per 1000 person-years). This compared with an incidence rate of 10.7 per 1000 person-years in matched reference individuals, corresponding to a 2.53-fold increased hazard of serious infections (95%CI = 2.47–2.59). The HR for serious infection in elderly-onset IBD was 2.01 (95%CI = 1.95–2.08). The relative hazard of serious infection was somewhat higher in Crohn’s disease (2.94; 95%CI = 2.81–3.06) than in ulcerative colitis (2.24; 95%CI = 2.17–2.31). The HR for serious infections was high in the first year of follow-up (5.17; 95%CI = 4.93–5.42). Individuals with IBD were at a particularly high relative hazard of gastrointestinal and opportunistic infections. The HR for sepsis was 2.47 (95%CI = 2.32–2.63). The relative rates for serious infections in IBD increased in recent years. Conclusions: Patients with adult-onset IBD are at increased risk of serious infections, particularly gastrointestinal and opportunistic infections. Relative rates were highest just after IBD diagnosis, and seem to have increased in recent years.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Crohn’s disease, IBD, IBD unclassified, indeterminate IBD, ulcerative colitis
in
Scandinavian Journal of Gastroenterology
volume
56
issue
10
pages
11 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85112650234
  • pmid:34369254
ISSN
0036-5521
DOI
10.1080/00365521.2021.1924259
language
English
LU publication?
no
id
06293338-7f9a-4d98-a66f-a114dff85904
date added to LUP
2021-09-23 15:44:26
date last changed
2022-08-04 19:09:26
@article{06293338-7f9a-4d98-a66f-a114dff85904,
  abstract     = {{<p>Objectives: To investigate absolute and relative risk of serious infections in adult/elderly inflammatory bowel disease (IBD) diagnosed 2002–2017. Methods: Nationwide, register-based cohort study of Swedish patients with IBD compared with general population matched reference individuals with regard to time to first serious infection, equal to hospital admission. Multivariable Cox regression estimated hazard ratios (HRs) for any serious infection. Secondary outcomes included site-specific infections, opportunistic infections and sepsis. Results: We identified 47 798 individuals with IBD. During a follow-up of 329 000 person-years, they had 8752 first serious infections (26.6 per 1000 person-years). This compared with an incidence rate of 10.7 per 1000 person-years in matched reference individuals, corresponding to a 2.53-fold increased hazard of serious infections (95%CI = 2.47–2.59). The HR for serious infection in elderly-onset IBD was 2.01 (95%CI = 1.95–2.08). The relative hazard of serious infection was somewhat higher in Crohn’s disease (2.94; 95%CI = 2.81–3.06) than in ulcerative colitis (2.24; 95%CI = 2.17–2.31). The HR for serious infections was high in the first year of follow-up (5.17; 95%CI = 4.93–5.42). Individuals with IBD were at a particularly high relative hazard of gastrointestinal and opportunistic infections. The HR for sepsis was 2.47 (95%CI = 2.32–2.63). The relative rates for serious infections in IBD increased in recent years. Conclusions: Patients with adult-onset IBD are at increased risk of serious infections, particularly gastrointestinal and opportunistic infections. Relative rates were highest just after IBD diagnosis, and seem to have increased in recent years.</p>}},
  author       = {{Ludvigsson, Jonas F. and Holmgren, Johanna and Grip, Olof and Halfvarson, Jonas and Askling, Johan and Sachs, Michael C. and Olén, Ola}},
  issn         = {{0036-5521}},
  keywords     = {{Crohn’s disease; IBD; IBD unclassified; indeterminate IBD; ulcerative colitis}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1152--1162}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{Adult-onset inflammatory bowel disease and rate of serious infections compared to the general population : a nationwide register-based cohort study 2002–2017}},
  url          = {{http://dx.doi.org/10.1080/00365521.2021.1924259}},
  doi          = {{10.1080/00365521.2021.1924259}},
  volume       = {{56}},
  year         = {{2021}},
}