Disease outcome in inflammatory bowel disease: Mortality, morbidity and therapeutic management of a 796-person inception cohort in the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD)

Background: The course of inflammatory bowel diseases (IBD) has mainly been studied using different methods in single patient cohorts. The aim of the present study was to assess clinical aspects of disease outcome in a popula tion-based cohort of IBD patients over a 3-year period in multiple centres across Europe. Methods: A total of 796 patients with LED diagnosed in 10 ce ntres between October 1991 and October 1993, registered at the EC IBD study centre (98% of the original cohort), participated in the study. Investigat ors filled out a standard follow-up form containing questions on the method of follow-up, vital status of the patient, change in diagnosis, extraintes tinal manifestations, medical and surgical treatment: and physician's globa l assessment of disease activity. Results: Complete relief of the complaint s was reported in 255 (48%) patients with ulcerative colitis (UC), 9 (50%) with indeterminate colitis (IC), but only in 87 (35%) of patients with Croh n disease (CD). Improvement was reported in 195 (37%) patients with UC, 113 (45%) with CD and 6 (33%) with IC. During the 4-year follow-up period, 23 patients died (14 UC, 8 CD, and 1 IC). The mean age at death was 69.3 years (s, 14.9 years). The deaths of three patients were recorded as directly du e to PBD. Conclusions: With the present approach to therapeutic management the short-term outcome of patients with IBD seems to be favourable in 10 me dical centres in the north and south of Europe. However, more detailed stud ies including both objective and subjective measures are necessary.