Pediatric inflammatory bowel disease: Increasing incidence, decreasing surgery rate, and compromised nutritional status: A prospective population-based cohort study 2007–2009
✍ Scribed by Christian Jakobsen; Anders Paerregaard; Pia Munkholm; Jan Faerk; Aksel Lange; Jesper Andersen; Marianne Jakobsen; Iza Kramer; Janina Czernia-Mazurkiewicz; Vibeke Wewer
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 428 KB
- Volume
- 17
- Category
- Article
- ISSN
- 1078-0998
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✦ Synopsis
Background:
The aim was to evaluate the incidence, treatment, surgery rate, and anthropometry at diagnosis of children with inflammatory bowel disease (ibd).
Methods:
Patients diagnosed between january 1, 2007 to december 31, 2009 in eastern denmark, funen, and aarhus were included from a background population of 668,056 children <15 years of age. for evaluation of incidence, treatment, and surgery rate, a subcohort from eastern denmark was extracted for comparison with a previously published population-based cohort from the same geographical area (1998-2006).
Results:
In all, 130 children with ibd: 65 with crohn's disease (cd), 62 with ulcerative colitis (uc), and three with ibd unclassified (ibdu) were included. the mean incidence rates per 10(6) in 2007-2009 were: ibd: 6.4 (95% confidence interval [ci]: 5.4-7.7), cd: 3.2 (2.5-4.1), uc: 3.1 (2.4-4.0) and ibdu: 0.2 (0.05-0.5). comparing the two cohorts from eastern denmark we found higher incidence rates for ibd (5.0 and 7.2 in 1998-2000 and 2007-2009, respectively, p = 0.02) and cd (2.3 versus 3.3, p = 0.04). furthermore, we found a significant decrease in surgery rates (15.8/100 person-years versus 4.2, p = 0.02) and an increase in the rate of initiating immunomodulators (im) within the first year (29.0/100 person-years versus 69.2, p < 0.001). im use was associated with a trend towards a decreased surgery risk (relative risk [rr] 0.38; 0.15-1.0). children with cd had poor nutritional status at diagnosis compared with the general pediatric population.
Conclusions:
Over the past 12 years we found an increase in the incidence of ibd in children, an increasing use of im, and decreasing 1-year surgery rates. cd patients had poor nutritional status.