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Article: Epidemiology and Natural History of Elderly-onset inflammatory bowel disease: Results from a territory-wide Hong Kong IBD registry

TitleEpidemiology and Natural History of Elderly-onset inflammatory bowel disease: Results from a territory-wide Hong Kong IBD registry
Authors
KeywordsElderly-onset IBD
epidemiology
clinical outcomes
Issue Date2021
PublisherOxford University Press. The Journal's web site is located at http://ecco-jcc.oxfordjournals.org/
Citation
Journal of Crohn's and Colitis, 2021, v. 15 n. 3, p. 401-408 How to Cite?
AbstractBackground: 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 to 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 to 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 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&.001) than adult-onset. 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 hospitalization (OR: 1.14; 95% CI 1.09-1.20; p&0.001), infections-related hospitalization (OR: 1.87; 95% CI 1.47-2.38; p&0.001) and IBD-related hospitalization (OR: 1.09; 95% CI: 1.04- 1.15; p=0.001) compared to adult-onset IBD. Conclusion: Elderly-onset IBD patients were associated with increased risk of infections, cancer development and increased infections- and IBD-related hospitalizations. Specific therapeutic strategies to target this special population is needed.
Persistent Identifierhttp://hdl.handle.net/10722/287680
ISSN
2020 Impact Factor: 9.071
2015 SCImago Journal Rankings: 1.543

 

DC FieldValueLanguage
dc.contributor.authorMak, JWY-
dc.contributor.authorHo, CLT-
dc.contributor.authorWong, K-
dc.contributor.authorCheng, TY-
dc.contributor.authorYip, TCF-
dc.contributor.authorLeung, WK-
dc.contributor.authorLi, M-
dc.contributor.authorLo, FH-
dc.contributor.authorNg, KM-
dc.contributor.authorSze, SF-
dc.contributor.authorLeung, CM-
dc.contributor.authorTsang, SWC-
dc.contributor.authorShan, EHS-
dc.contributor.authorChan, KH-
dc.contributor.authorLam, BCY-
dc.contributor.authorHui, AJ-
dc.contributor.authorChow, WH-
dc.contributor.authorNg, SC-
dc.date.accessioned2020-10-05T12:01:40Z-
dc.date.available2020-10-05T12:01:40Z-
dc.date.issued2021-
dc.identifier.citationJournal of Crohn's and Colitis, 2021, v. 15 n. 3, p. 401-408-
dc.identifier.issn1873-9946-
dc.identifier.urihttp://hdl.handle.net/10722/287680-
dc.description.abstractBackground: 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 to 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 to 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 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&.001) than adult-onset. 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 hospitalization (OR: 1.14; 95% CI 1.09-1.20; p&0.001), infections-related hospitalization (OR: 1.87; 95% CI 1.47-2.38; p&0.001) and IBD-related hospitalization (OR: 1.09; 95% CI: 1.04- 1.15; p=0.001) compared to adult-onset IBD. Conclusion: Elderly-onset IBD patients were associated with increased risk of infections, cancer development and increased infections- and IBD-related hospitalizations. Specific therapeutic strategies to target this special population is needed.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://ecco-jcc.oxfordjournals.org/-
dc.relation.ispartofJournal of Crohn's and Colitis-
dc.rightsPre-print: Journal Title] ©: [year] [owner as specified on the article] Published by Oxford University Press [on behalf of xxxxxx]. All rights reserved. Pre-print (Once an article is published, preprint notice should be amended to): This is an electronic version of an article published in [include the complete citation information for the final version of the Article as published in the print edition of the Journal.] Post-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here].-
dc.subjectElderly-onset IBD-
dc.subjectepidemiology-
dc.subjectclinical outcomes-
dc.titleEpidemiology and Natural History of Elderly-onset inflammatory bowel disease: Results from a territory-wide Hong Kong IBD registry-
dc.typeArticle-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.authorityLeung, WK=rp01479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ecco-jcc/jjaa181-
dc.identifier.pmid32914171-
dc.identifier.hkuros315341-
dc.identifier.volume15-
dc.identifier.issue3-
dc.identifier.spage401-
dc.identifier.epage408-
dc.identifier.eissn1876-4479-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1873-9946-

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