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At least 343 records · Page 19Linked to original sources
PubMed2006

Hospitalization, surgery, and readmission rates of IBD in Canada: a population-based study.

BACKGROUND: We aimed to define the rates of hospitalization and readmission for inflammatory bowel disease in Canada. METHODS: The data source was Statistics Canada Person Oriented Information Database (1994-2001). The number of stays for a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) by ICD-9-CM code 555 or 556 was extracted (and assessed when CD or UC was the first diagnosis or was 1 of 16 diagnoses on the patient discharge abstract). Age-, gender-, and disease-specific rates of hospitalization, length of stay, readmission, and surgery were assessed. RESULTS: The age-adjusted hospitalization rate for CD declined over 1994-2001 from 29.2 to 26.9/100,000 but was stable for UC at 12.6-13.3 per 100,000. In the 7 yr, 39.4% of CD patients (21.3-24.0%/yr) and 33.7% of UC patients (18.5-20.3%/yr) got readmitted at least once. The average length of stay declined from 10.3 (1994-1995) to 9.1 days (2000-2001) (p = 0.029) in CD and in UC declined from 12.2 to 10.1 days (p = 0.054). Of all hospitalizations, major surgery occurred in 48% of CD (44.8-49.8% per yr) and 55% of UC (51.5-59.0% per yr). CONCLUSIONS: Rates of hospitalization declined slightly for CD over the 7 yr but still remained twice as great as the rates for UC. Approximately 20% of CD and UC subjects got readmitted per year and over 7 yr approximately 35% got readmitted. Major surgery was a more common reason for hospitalization in UC than in CD.

Adolescent↗
PubMed2006

Sensitivity-specificity trade-off for capsule endoscopy in IBD: is it worth it?

There are a growing number of reports comparing wireless capsule endoscopy (CE) to other diagnostic tests for use in patients with Crohn's disease. A meta-analysis of these studies in this issue of the Journal showed that the "diagnostic yield" of detecting lesions suggestive of active Crohn's disease is much higher with CE compared to other tests. Routine use of CE in Crohn's disease will increase true-positive testing, but also will increase the number of false-positive tests. Since the penalty of false-positive testing is very high (unnecessary use of toxic and expensive medications, and the stigma of being diagnosed with a serious chronic disease), CE should be used only in limited clinical situations. In particular, CE may be helpful in Crohn's disease patients without a stricture whose physician needs an added measure of certainty that active disease is present.

Capsules↗
PubMed2004

Divergent patterns of total and cancer mortality in ulcerative colitis and Crohn's disease patients: the Florence IBD study 1978-2001.

BACKGROUND AND AIMS: Two divergent patterns of mortality for smoking related diseases in ulcerative colitis and Crohn's disease patients were suggested in a previous population based study in Florence, Italy. Long term follow up (median 15 years) was completed to re-evaluate mortality in this Mediterranean cohort. PATIENTS AND METHODS: Overall, 920 patients with inflammatory bowel disease were followed until December 2001 or death, with seven patients (0.8%) lost to follow up. A total of 14 040 person years were available for analysis; 118 deaths were observed (81/689 in ulcerative colitis and 37/231 in Crohn's disease). Expected deaths were estimated using age, sex, and calendar specific national and local mortality rates; standardised mortality ratios (SMR) and 95% confidence interval (CI) were calculated. RESULTS: Among Crohn's disease patients, mortality was strongly increased for gastrointestinal diseases (SMR 4.49 (95% CI 1.80-9.25)), all cancers (SMR 2.10 (95% CI 1.22-3.36)), and lung cancer (SMR 4.00 (95% CI 1.60-8.24)), leading to a significant 50% excess total mortality. Ulcerative colitis patients showed a significantly reduced total mortality because of lower cardiovascular (SMR 0.67 (95% CI 0.45-0.95)) and lung cancer (SMR 0.32 (95% CI 0.07-0.95)) mortality. No significant excess for colorectal cancer mortality was evident in this extended follow up. CONCLUSIONS: These clearly divergent patterns of mortality correlate with documented differences in smoking habits between Crohn's disease and ulcerative colitis patients. Family doctors and gastroenterologists should consider stopping cigarette smoking a specific priority for Crohn's disease patients; the latter should be offered free participation in structured programmes for smoking cessation, with the aim of reducing smoking related excess mortality. Overall, no evidence of an increased mortality for large bowel cancer emerged in this series.

Adult↗
PubMed2005

New IBD genes?

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Chromosomes, Human↗