Meta-analysis: mortality in Crohn’s disease
Article first published online: 12 FEB 2007
Alimentary Pharmacology & Therapeutics
Volume 25, Issue 8, pages 861–870, April 2007
How to Cite
CANAVAN, C., ABRAMS, K. R. and MAYBERRY, J. F. (2007), Meta-analysis: mortality in Crohn’s disease. Alimentary Pharmacology & Therapeutics, 25: 861–870. doi: 10.1111/j.1365-2036.2007.03276.x
- Issue published online: 30 MAR 2007
- Article first published online: 12 FEB 2007
- Publication data Submitted 13 December 2006 First decision 25 January 2007 Resubmitted 29 January 2007 Resubmitted 31 January 2007 Accepted 4 February 2007
Aim To perform a meta-analysis is of published literature reporting standardized mortality ratios (SMR) for Crohn’s patients from 1970 to date.
Methods Medline search identified relevant papers. Exploding references identified additional papers. When two papers reviewed mortality of one patient group at different times, the later publication was used.
Results Of 13 papers identified, three studies reported SMR below 1.0, two others had confidence intervals including 1.0. All other studies reported mortality higher than the general population. Meta-analysis using a random effects model shows the pooled estimate for SMR in Crohn’s disease is 1.52 (95% CI: 1.32 to 1.74 [P < 0.0001]). Meta-regression shows the SMR for these patients has decreased slightly over the past 30 years, but this decrease is not statistically significant (P = 0.08).
Conclusion Assessing evidence from original studies and conducting a meta-analysis shows age-adjusted mortality risk from Crohn’s disease is over 50% greater than the general population. Whilst mortality has improved since the condition was first recognized, further evaluation of the patients studied in the cohorts included here is necessary to assess more recent changes in clinical practice.