Here are two recent articles on mortality in Crohn's Disease with links for you if you REALLY want to know this stuff. Basically, the bottom line is yes, statistically your life is going to be shorter, mortality in CD is highest in the first 5 years after diagnosis, surgery is risky business, your life expectancy is shortened considerably if you were diagnosed before age 20 and prednisone, narcotics and moderate-severe CD are associated with severe infections more than remicade use. Guess that explains why no one wants to sell you life insurance.
Patricia (son, 11, CD, Humira, 6-MP, Omeprazole, Miralax, supplements)
Increased Infections and Mortality with Certain Crohn's Therapies
Although mortality rates are similar between therapies for Crohn's disease, the latest Clinical Gastroenterology & Hepatology finds that prednisone is associated with increased mortality, and infliximab increases the risk of serious infection....
The team found that the mortality rates were similar for infliximab- and non-infliximab-treated patients. In multivariate logistic regression analysis, only prednisone was associated with an increased mortality risk. The team showed an increased risk for infection with infliximab use, using unadjusted analysis. However, multivariate logistic regression analysis suggested that infliximab was not an independent predictor of serious infections. Factors independently associated with serious infections included prednisone use, narcotic analgesic use and moderate-to-severe disease activity. – Newsfeed from GastroHep.com
Clinical Gastroenterology & Hepatology; 2006: 4(5): 621-30
Meta-Analysis:Mortality in Crohn's Disease
The risk of dying for patients with Crohn's disease is over 50% higher than would be expected for someone in the general population of the same age and sex. This is reflected in a recent long-term study of prognosis for patients with Crohn's disease in Cardiff, which showed reduced life expectancy for all patients, especially those diagnosed before the age of 20. Overall life expectancy for men diagnosed with Crohn's disease in the Cardiff cohort was 77.3 years and 79.0 years for women, those diagnosed before the age of 20 had a median age at death of 64 years. Life expectancy of the general population over the study period was 71 for males and 77 for females..
There is a greatly increased mortality risk for patients who have been diagnosed less than 5 years,[11,32,33,41] the majority of whom die due to surgical complications. In future this may need to be reflected in consultations with newly diagnosed patients. Patients who die later have a high incidence of gastrointestinal cancer and renal disease. Mortality is also reported to be highest in patients diagnosed under 20 years old[32,33,41] and women diagnosed before the age of 50 years. Smoking is associated with Crohn's disease and the excess mortality seen in these studies may be partly because of this habit. In a recent study in Florence patients with Crohn's disease were shown to have a significantly raised SMR for gastrointestinal disease, all cancers and specifically lung cancer (4.49, 2.10 and 4.00 respectively); 70% of these patients were current or former smokers. Consequently, smoking is a confounding factor when analyzing mortality in Crohn's disease, however, a nationwide British study that adjusted for this characteristic still showed patients to have a higher SMR than the general population.
Aliment Pharmacol Ther. 2007;25(8):861-870. ©2007 Blackwell Publishing
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