Mortality and causes of death in patients with chronic inflammatory bowel disease in Gijon, Asturias (Spain)

OBJECTIVE: to review mortality, survival, influence of age at diagnosis and at death, cause of death, and relation with the extent of chronic inflamma tory bowel disease, in a city in northern Spain. METHOD: descriptive retrospective epidemiological study of 516 patients dia gnosed in Gijon (Asturias) between 1954 and 1997. RESULTS: Of the 26 patients who died (5.03%), 18 had ulcerative colitis, 8 had Crohn's disease, and none had indeterminate colitis. Mortality was high er than in the general population, with a standard mortality ratio (SMR) of 5 (95% confidence interval 1.6-11.6). We found no differences in sex ratio (p=0.63). Mean duration of the disease was 10 +/- 8 years in surviving pat ients, and 6 +/- 6 years in patients who died (p = 0.02). Duration was long er in Crohn's disease than in ulcerative colitis (p = 0.014). Mean age at d iagnosis for chronic inflammatory bowel disease was 37.5 +/- 17 years in pa tients who survived, and 58 +/- 18 years in patients who died (p = 0.0005). Mean age at death was 64 +/- 20 years. In Crohn's disease, the most freque nt cause of death was the primary disease (50%), followed by tumors of diff erent origin (37.5%). In ulcerative colitis the primary disease was also th e most frequent cause of death (38.%), followed by thromboembolic disease ( 22.2%) and tumors (22.2%). CONCLUSIONS: mortality among patients with chronic inflammatory bowel disea se is higher than in the general population in our setting, decreases as du ration of the disease increases, and is higher in patients diagnosed at old er ages. Fewer than half the deaths were due to the primary disease; many p atients with Crohn's disease died from tumors or thromboembolic disease.