All-cause mortality of hospitalized inflammatory bowel disease patients: a multicenter study from Iran

Abstract

AIM: In this multicenter study, we investigated all causes of mortality in hospitalized inflammatory bowel disease (IBD) patients. BACKGROUND: The widespread use of biologics and immune suppressive treatments, along with the longer lifespan of patients with IBD, may have changed the cause of death in this population. Knowing this may lead to better preventive and therapeutic strategies for IBD patients. METHODS: This cross-sectional study reviewed records of 1926 IBD patients hospitalized in referral hospitals in Isfahan and Shiraz during 2013-2021. In nine years, 84 patients, 39 from Isfahan and 45 from Shiraz, died. We retrospectively gathered data on demographic, clinical, and laboratory information, as well as the cause of death. We extracted the cause of death from the death sheets and classified it using the International Classification of Diseases (ICD-10). Using the Kaplan-Meier model, we estimated the median survival time from disease diagnosis to death. RESULTS: Males accounted for 47 (55) of the deceased patients. The mean age of the patients was 48.63 +/- 18.7 years. The mortality rates among hospitalized UC and CD patients were 7.2 and 7.8, respectively. The median duration of admission to death was 8 days, with 19 (22.6) of IBD patients dying on the first day of their hospital admission. Half of the cohort of deceased IBD patients had survived for 8 years following their disease diagnosis. 32.7 of all recorded causes of death were due to certain infectious diseases. The second and third most common causes of death were diseases of the digestive system and diseases of the circulatory system, including pulmonary embolism, accounting for 30.1 and 14.2, respectively. CONCLUSION: According to this study from Iran, infectious diseases are the leading cause of death among hospitalized IBD patients. Prevention and clinical management of pulmonary embolism in IBD patients require more careful consideration. We strongly encourage population-based cohort studies to enhance the findings.