| 1. |
- Eberhardson, Michael, et al.
(författare)
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Tumour necrosis factor inhibitors in Crohn's disease and the effect on surgery rates
- 2022
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Ingår i: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 24:4, s. 470-483
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Surgery is an important therapeutic option for Crohn's disease. The need for first bowel surgery seems to have decreased with the introduction of tumour necrosis factor inhibitors (TNFi; adalimumab or infliximab). However, the impact of TNFi on the need for intestinal surgery in Crohn's disease patients irrespective of prior bowel resection is not known. The aim of this work is to compare the incidence of bowel surgery in Crohn's disease patients who remain on TNFi treatment versus those who discontinue it. Method: We performed a nationwide register-based observational cohort study in Sweden of all incident and prevalent cases of Crohn's disease who started first-line TNFi treatment between 2006 and 2017. Patients were categorized according to TNFi treatment retention less than or beyond 1 year. The study cohort was evaluated with regard to incidence of bowel surgery from 12 months after the first ever TNFi dispensation. Results: We identified 5003 Crohn's disease patients with TNFi exposure: 3748 surgery naïve and 1255 with bowel surgery prior to TNFi initiation. Of these patients, 7% (n = 353) were subjected to abdominal surgery during the first 12 months after the start of TNFi and were subsequently excluded from the main analysis. A majority (62%) continued TNFi for 12 months or more. Treatment with TNFi for less than 12 months was associated with a significantly higher surgery rate compared with patients who continued on TNFi for 12 months or more (hazard ratio 1.26, 95% CI 1.09–1.46; p = 0.002). Conclusion: Treatment with TNFi for less than 12 months was associated with a higher risk of bowel surgery in Crohn's disease patients compared with those who continued TNFi for 12 months or more.
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| 2. |
- Langefeld, Carl D., et al.
(författare)
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Transancestral mapping and genetic load in systemic lupus erythematosus
- 2017
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Ingår i: Nature Communications. - : NATURE PUBLISHING GROUP. - 2041-1723. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Systemic lupus erythematosus (SLE) is an autoimmune disease with marked gender and ethnic disparities. We report a large transancestral association study of SLE using Immunochip genotype data from 27,574 individuals of European (EA), African (AA) and Hispanic Amerindian (HA) ancestry. We identify 58 distinct non-HLA regions in EA, 9 in AA and 16 in HA (similar to 50% of these regions have multiple independent associations); these include 24 novel SLE regions (P < 5 x 10(-8)), refined association signals in established regions, extended associations to additional ancestries, and a disentangled complex HLA multigenic effect. The risk allele count (genetic load) exhibits an accelerating pattern of SLE risk, leading us to posit a cumulative hit hypothesis for autoimmune disease. Comparing results across the three ancestries identifies both ancestry-dependent and ancestry-independent contributions to SLE risk. Our results are consistent with the unique and complex histories of the populations sampled, and collectively help clarify the genetic architecture and ethnic disparities in SLE.
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| 3. |
- Mårild, Karl, 1982, et al.
(författare)
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Histologic activity in inflammatory bowel disease and risk of serious infections : A nationwide study
- 2024
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 22:4, s. 831-846
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Individuals with inflammatory bowel disease (IBD) are at increased risk of serious infections, but whether this risk varies by histological disease activity is unclear.METHODS: A national population-based study of 55,626 individuals diagnosed with IBD in 1990-2016 with longitudinal data on ileo-colorectal biopsies followed through 2016. Serious infections were defined as having an inpatient infectious disease diagnosis in the Swedish National Patient Register. We used Cox regression to estimate hazard ratios (HRs) for serious infections in the 12 months following documentation of histologic inflammation (vs. histological remission), adjusting for social and demographic factors, chronic comorbidities, prior IBD-related surgery and hospitalization. We also adjusted for IBD-related medications in sensitivity analyses.RESULTS: With histological inflammation vs. remission, there was 4.62 (95%CI=4.46-4.78) and 2.53 (95%CI=2.36-2.70) serious infections per 100 person-years of follow-up, respectively (adjusted [a]HR=1.59; 95%CI=1.48-1.72). Histological inflammation (vs. remission) were associated with an increased risk of serious infections in ulcerative colitis (UC, aHR=1.68; 95%CI=1.51-1.87) and Crohn's disease (CD, aHR=1.59; 95%CI=1.40-1.80). The aHRs of sepsis and opportunistic infections were 1.66 (95%CI=1.28-2.15) and 1.71 (95%CI=1.22-2.41), respectively. Overall, results were consistent across age groups, sex and education level and remained largely unchanged after adjustment for IBD-related medications (aHR=1.47; 95%CI=1.34-1.61).CONCLUSION: Histological inflammation of IBD was an independent risk factor of serious infections, including sepsis, suggesting that achieving histological remission may reduce infections in IBD.
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| 4. |
- Ludvigsson, Jonas F., 1969-, et al.
(författare)
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Swedish Inflammatory Bowel Disease Register (SWIBREG) : a nationwide quality register
- 2019
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 54:9, s. 1089-1101
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Forskningsöversikt (refereegranskat)abstract
- Background: Inflammatory bowel disease (IBD) is a chronic, inflammatory relapsing disease with increasing incidence. IBD research and long-term follow-up of patients have, however, been hampered by lack of detailed data on disease phenotype, patient-reported outcome measures, Physician Global Assessment, disease activity, and hospital-administered drugs.Aim: To review the Swedish IBD quality register (SWIBREG).Methods: Review of SWIBREG including questionnaire data from users and patients.Results: SWIBREG was launched in 2005, and as of April 2019, contains 46,400 patients with IBD (Crohn's disease: n = 15,705, ulcerative colitis: n = 21,540, IBD unclassified and other colitis (including e.g., microscopic colitis): n = 9155). Of these IBD patients, 7778 had been diagnosed in childhood (16.8%). Earlier research has shown that combining SWIBREG and the Swedish National Patient Register (NPR) yields a positive predictive value of 100% (95%CI = 95-100%) for having a diagnosis of IBD. Moreover, out of all patients in the NPR with a diagnosis of IBD plus either IBD-related surgery or immunomodulatory/biological treatment during the past 18 months, SWIBREG covers 59.0%. SWIBREG records not only information on conventional therapies but also on biological treatment, surgery, smoking, disease activity, patient-reported outcome measures (PROMs), and patient-experienced measures (PREMs). Data are presented through a graphical decision support system.Conclusion: SWIBREG benefits patients with IBD, and offers an ideal opportunity for healthcare personnel and researchers to examine disease phenotype and activity, PROMs/PREMs, and hospital-administered drugs in patients with IBD.
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| 5. |
- Olén, Ola, et al.
(författare)
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Increasing Risk of Lymphoma Over Time in Crohn's Disease but Not in Ulcerative Colitis : A Scandinavian Cohort Study
- 2023
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 21:12, s. 3132-3142
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Earlier studies have provided varying risk estimates for lymphoma in patients with inflammatory bowel disease (IBD), but often have been limited by detection biases (especially during the first year of follow-up evaluation), misclassification, and small sample size; and rarely reflect modern-day management of IBD.Methods: We performed a binational register-based cohort study (Sweden and Denmark) from 1969 to 2019. We compared 164,716 patients with IBD with 1,639,027 matched general population reference individuals. Cox regression estimated hazard ratios (HRs) for incident lymphoma by lymphoma subtype, excluding the first year of follow-up evaluation.Results: From 1969 to 2019, 258 patients with Crohn's disease (CD), 479 patients with ulcerative colitis (UC), and 6675 matched reference individuals developed lymphoma. This corresponded to incidence rates of 35 (CD) and 34 (UC) per 100,000 person-years in IBD patients, compared with 28 and 33 per 100,000 person-years in their matched reference individuals. Although both CD (HR, 1.32; 95% CI, 1.16–1.50) and UC (HR, 1.09; 95% CI, 1.00–1.20) were associated with an increase in lymphoma, the 10-year cumulative incidence difference was low even in CD patients (0.08%; 95% CI, 0.02–0.13). HRs have increased in the past 2 decades, corresponding to increasing use of immunomodulators and biologics during the same time period. HRs were increased for aggressive B-cell non-Hodgkin lymphoma in CD and UC patients, and for T-cell non-Hodgkin lymphoma in CD patients. Although the highest HRs were observed in patients exposed to combination therapy (immunomodulators and biologics) or second-line biologics, we also found increased HRs in patients naïve to such drugs.Conclusions: During the past 20 years, the risk of lymphomas have increased in CD, but not in UC, and were driven mainly by T-cell lymphomas and aggressive B-cell lymphomas.
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| 6. |
- Shrestha, Sarita, 1991-, et al.
(författare)
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The use of ICD codes to identify IBD subtypes and phenotypes of the Montreal classification in the Swedish National Patient Register
- 2020
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 55:4, s. 430-435
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Whether data on International Classification of Diseases (ICD)-codes from the Swedish National Patient Register (NPR) correctly correspond to subtypes of inflammatory bowel disease (IBD) and phenotypes of the Montreal classification scheme among patients with prevalent disease is unknown. Materials and methods: We obtained information on IBD subtypes and phenotypes from the medical records of 1403 patients with known IBD who underwent biological treatment at ten Swedish hospitals and retrieved information on their IBD-associated diagnostic codes from the NPR. We used previously described algorithms to define IBD subtypes and phenotypes. Finally, we compared these register-generated subtypes and phenotypes with the corresponding information from the medical records and calculated positive predictive values (PPV) with 95% confidence intervals. Results: Among patients with clinically confirmed disease and diagnostic listings of IBD in the NPR (N = 1401), the PPV was 97 (96-99)% for Crohn's disease, 98 (97-100)% for ulcerative colitis, and 8 (4-11)% for IBD-unclassified. The overall accuracy for age at diagnosis was 95% (when defined as A1, A2, or A3). Examining the validity of codes representing disease phenotype, the PPV was 36 (32-40)% for colonic Crohn's disease (L2), 61 (56-65)% for non-stricturing/non-penetrating Crohn's disease behaviour (B1) and 83 (78-87)% for perianal disease. Correspondingly, the PPV was 80 (71-89)% for proctitis (E1)/left-sided colitis (E2) in ulcerative colitis. Conclusions: Among people with known IBD, the NPR is a reliable source of data to classify most subtypes of prevalent IBD, even though misclassification commonly occurred in Crohn's disease location and behaviour and also among IBD-unclassified patients.
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| 7. |
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| 9. |
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| 10. |
- Bengtsson, Stefan L., 1978-, et al.
(författare)
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Fiction Science and the Role of Theory in ESE
- 2023
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Konferensbidrag (refereegranskat)abstract
- This presentation will conceptualize fiction science and the derived potential for the ESE field (Bengtsson & Lysgaard, 2023). Fiction science can be seen as a form of paying homage to realism in science, where we see the acknowledgement of realism as to open up again the facticity of how things are. Fiction science as a genre we would like to introduce plays with this openness of facticity, as acknowledged in the scientific tradition to scepticism, in order to play with potential futures and pasts that can be seen to be partially informed by generally perceived truth(s) and partially informed by fiction, where do not yet/any longer know if that fiction is turning out to be a “truth”. We consider fiction science to engage with the challenges to human exceptionalism that the Anthropocene can be interpreted to impose on us. This rests on the acknowledgement that an empirically founded experience of the world in the “present” focusing on the human senses and self-conception is out of tune with the strange times we live in (Bengtsson & Lysgaard, 2022). To put it simply, we are increasingly becoming aware that the projected facticity of our understanding of ourselves and the world is lacking in “truthiness”, and that what is and has been is apparently different than we thought (Saari & Mullen, 2020). Fiction science relates, in this sense, to the possibility of things existing in the past, present and future at the same time (Bengtsson & Lysgaard, 2023). Fiction science taps into an openness or the intervention of a past and future that we as humans do not have access to. The fictive or imaginative aspects of fiction science can not be “contained” to a imagined and non-factual future or past but rather have a Schrödinger's cat state where the future is open and the fictive aspect of its prediction can turn out to be a seemingly “fact” in the future (cf. Harman, 2012). In our presentation we will engage with the question of what fiction science might mean for the conception of theory in ESE research as well its delineation from data- or practice-driven research.
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| 11. |
- Bengtsson, Stefan L., 1978-, et al.
(författare)
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Immersion and ritual in Object-Oriented Didactics and Sensuous Learning
- 2021
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Konferensbidrag (refereegranskat)abstract
- Environmental and sustainability education (ESE) that wants to address existing environmental and sustainability challenges is basically critical, that is if it wants to change through education and learning contemporary ways of being in the world (cf Hart & Nolan 1999). This change is often framed in terms of transformation, where something is changed into something else, yet, that change of that something (van Poeck, König & Wals 2018; Lundegård & Wickman 2009), for example the process, is partially a retainment of something (Mezirow 2000). For example, it is still the social, learner, knowledge or custom that was transformed, highlighting its continuity. This focus on retainment and continuity has recently been challenged through the concept of transgressive learning (e.g. Lotz-Sisitka et al. 2015), where the focus is rather of abandonment and discontinuity of ways of being through learning (Bengtsson 2019). Transgression is by the presenting authors seen as a means of potentially subverting the reproduction of coloniality of Western thought (Chaves et al. 2015), pertaining anthropocentrism (Kopnina 2012) and capitalism/neoliberalism (Hursh, Henderson & Greenwood 2015) in and through ESE.This paper aims to contribute to a theoretical and practical development of didactical means for transgression, particularly by providing alternative pedagogical and didactical entry points for understanding learning as not primarily rational but by highlighting aesthetics and the sensuous learner. In this effort, the paper combines the theoretical outlooks of sensuous learning (Hallberg 2015, 2017, 2018) and object-oriented learning (Bengtsson 2018) in order to develop further a object-oriented didactics of ESE (Bengtsson, Lysgaard, Jordt-Joergensen 2019). The effort is here to provide theoretical and practical means for engaging with withdrawn and uncanny objects of education through sensuous learning. Drawing on the initial considerations of object-oriented didactics (Bengtsson, Lysgaard, Jordt-Joergensen 2019) holding that the real object of education is not congruent with the content of education and that the educative substance (Bildungsgehalt) of the object of education is indeterminate (located in an open future) and infinite (given that the qualities of the object of education are always larger than any attempts to reduce it to a content of education), sensuous learning is here to provide entry points for understanding how the indeterminate and infinite qualities of the object of education can be rendered sensible.The paper will address the following research questions:How can didactic intervention engage with the surplus of the educative substance (Bildungssubstanz) of the object of education? (Practical question)How can senouse learning sensitize the learner and teacher to the indeterminate potential of the educative substance of the object as that substance is according to the axioms of object-oriented learning located in a future still to come? (Practical and theoretical question)How can we understand the contribution of object-oriented didactics to the production of a Sensuous Society (Hallberg 2017) and Ecological Bildung (Bengtsson, Lysgaard, Jordt-Joergensen 2019). How is this link actualized in didactical intervention and in learning? (Theoretical question)MethodThe paper represents a theoretical development of existing conceptions of a) transgressive learning, b) dark pedagogy and c) sensuous learning. In particular, it induces insights and perspectives from theory and methods in performance art and arts-based research into pedagogical and didactical research. Findings and models developed in Sisters Academy ́s school takeovers and boarding schools formats offer rich and innovative approaches to facilitating sensuous learning that are taken as inspiration for the development of object-oriented didactics. The Takeover format is meant to immerse the entire school into the sensuous and poetic and thus 'leave no one behind' in an attempt to democratize' the aesthetic. It is this all-embracing immersion that allows such democratization. However, the modes of participation can largely differ and is never forced and thus based on individual navigation within the overall educational experiment. This paper will in particular focus on two aspects of sensuous learning: immersion and the ritual. By engaging with approaches and models to immersion and the ritual, this paper is to explore in an open and creative manner how immersion and the ritual could be integrated into didactical interventions. Immersion, refers here also to the possibility of an immersion of the whole sensory spectrum, where the ritual might address different senses. The ritual is in this sense open and not already focused on particular senses or what is to be sensed.Expected OutcomesBy rendering partially sensible the object of education through didactic intervention, sensuous learning is resensitizing the learner to what in sensuous learning is called “Poetic Self” (Hallberg 2017, 2018) and in dark pedagogy is called “Future Self of Essence” (Bengtsson 2019b). Accordingly, educational substance (Bildungsgehalt) of the object of education to be engaged with in sensuous learning is not strictly speaking that of the object or “for me”. Instead, sensuous learning can be seen to lead to a transgression where the learner loses or ruins “its self”/”itself” (Bataille 1988). The poetic self is in this sense not engaging in the process of autopoiesis, i.e. self-reproduction and self-maintenance, finds itself caught up in “some thing”/”something”. The openness of the ritual and the process of object-oriented didactic gesture points here also the uncanny/unhomely (unheimlich) aspect of learning that is resensitizing to the Poetic Self/Future Self. The uncanniness refers here to a conception of self that is not strictly “in place”, but alienated and hence a self sensing self that is both itself and not-itself. Accordingly, the paper is to provide a reconception of understanding the positionality and limit of the self at the core of our understanding of learning. The combination of sensuous learning and object oriented didactics is in the context above to provide ecologically oriented entry points for ESE and for developing further transgressive learning.
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| 12. |
- Bengtsson, Stefan L., 1978-, et al.
(författare)
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Object-Oriented Didactics
- 2019
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Konferensbidrag (refereegranskat)abstract
- Current educational and especially didactical approaches are struggling to cope with sustainability and climate change issues. Sustainability issues in education do not respect disciplinary borders, compartmentalizations, and are not reducible to particular subjects of education, agendas on national education policies, nor do they fit into neatly definable categories like environmental or social issues. More significantly, sustainability issues challenge key assumptions underlying educational thought per se, as they not problems which can be solved alone by improving human learning and apprehension. That is, they are not reducible to discourse, practice, and knowledge. The way in which climate change appears to humans does not exhaust the issue or problem at hand, and, as opposed to various social challenges, we cannot simply choose to apprehend or engage with these processes differently and thereby (dis)solve them. Hence, climate change illustrates the inability of an idealist account of education and social response to sustainability issues. The very notion of climate change highlights the idealist anthropocentric fallacy to assume that a thing (the climate) is reducible to human apprehension (for us the climate is changing), as the climate has been there before humans and has been changing before humans are able to account for it (e.g. the ice ages). Education and social responses to global warming struggle for approaches to address those aspects of things that are beyond the possibility of human apprehension (climate without/before humans) and by their exclusion (reduction of climate to a climate for us) can be seen to reproduce structures in human practice that amplify the prevalence of sustainability issues. In this paper, we propose that the educational challenges of addressing issues like climate change a grounded in the subject-orientedness of education; the tendency to reduce an issue to the way in which it appears, affects and is manipulated by the human subject as learner. Hence, the issue is reduced to how it is an issue for the human subject, assuming a somewhat exclusive and self-centred (transcendental) position of the human to know and control an issue in practice. In education, this entails the reduction of an issue to a content of education that is to be engaged with by a student and under the didactical intervention of the teacher. As in the subject-oriented didactical triangle, the sustainability issues is reduced to a content of education that has a determinable educative potential (Bildungssubstanz/Bildungsgehalt) in relation to a human learner as well as to the teachers' disciplinary knowledge.This presentation aims to introduce an alternate didactical approach, an object-oriented didactics. The axiomatic starting point is here a reintroduction of the Kantian notion of the thing-in-itself that is not reducible to or congruent with a thing-for-us. Consequently, an object-oriented didactical approach differentiates between a content of education (Bildungsinhalt) and object of education (Bildungsgegenstand), where the object of education escapes the learner´s as well as teacher´s attempt to reduce it to a content of education with an determinable educative potential (Bildungssubstanz/Bildungsgehalt).The establishment of an axiomatic set of premises of an object-oriented didactics is to allow for a re-engagement with sustainability-related objects of education and with what their indeterminable educational potential means for didactical interventions and expected outcomes of education.
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| 13. |
- Bengtsson, Stefan L., 1978-, et al.
(författare)
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The Inherent Excess of Education
- 2019
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Konferensbidrag (refereegranskat)abstract
- The promise of education is Janus-faced. On one side it looks to the past and promises to reproduce it. Knowledge, practices and power are institutionalized through education in order to be passed from generation to generation. On the other side education looks to the future and promises to break with this reproduction. Through education, the future of privilege, insight and position is never certain (Säfström,2018). Even though political emphasis on reproducing yesterday’s growth pattern is still very much at the forefront in education, the growing number of sustainability issues show clearly education is, and must, be offering more than the stale reproduction of the problems that riddle our societies and planet. Her we focus on this inherent excess of education. Education always delivers something different than expected and this has become eminently clear with the emerging sustainability issues (Leicht, et al. 2018). First, we are to argue for excess to be the premise and limit of education. Second, this excess challenges current notions of temporality linked with the processes and outcomes of education. Third, this excess consequently haunts contemporary concepts used in order to conceive of education, that is reducing it to linear processes and determinable outcomes. Such conceptions need to be weak and vague given the inherent failure of education to function as a teleological mechanism. Thus we argue for the development of stronger concepts surrounding education in order to support the resilience of education in the face of challenges on three different levels: 1) subject/individual, 2) institutional, 3) societal. Our goal is to rethink education in order to forefront and grasp this inherent excess and how this relates directly to the inherent excess of sustainability issues. To conceive the beautiful risk of education in terms of its always lacking, messy, and gritty excess (Biesta, 2013). It is less of a linear process or journey, but an immanent condition of being a lacking and leaking human.
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| 15. |
- Ejlertsen, Bent, et al.
(författare)
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Similar efficacy for ovarian ablation compared with cyclophosphamide, methotrexate, and fluorouracil: from a randomized comparison of premenopausal patients with node-positive, hormone receptor-positive breast cancer
- 2006
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Ingår i: J Clin Oncol. - : American Society of Clinical Oncology (ASCO). - 1527-7755. ; 24:31, s. 4956-4962
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Tidskriftsartikel (refereegranskat)abstract
- To compare the efficacy of ovarian ablation versus chemotherapy in early breast cancer patients with hormone receptor–positive disease. Patients and Methods We conducted an open, randomized, multicenter trial including premenopausal breast cancer patients with hormone receptor–positive tumors and either axillary lymph node metastases or tumors with a size of 5 cm or more. Patients were randomly assigned to ovarian ablation by irradiation or to nine courses of chemotherapy with intravenous cyclophosphamide, methotrexate, and fluorouracil (CMF) administered every 3 weeks. Results Between 1990 and May 1998, 762 patients were randomly assigned, and the present analysis is based on 358 first events. After a median follow-up time of 8.5 years, the unadjusted hazard ratio for disease-free survival in the ovarian ablation group compared with the CMF group was 0.99 (95% CI, 0.81 to 1.22). After a median follow-up time of 10.5 years, overall survival (OS) was similar in the two groups, with a hazard ratio of 1.11 (95% CI, 0.88 to 1.42) for the ovarian ablation group compared with the CMF group. Conclusion In this study, ablation of ovarian function in premenopausal women with hormone receptor–positive breast cancer had a similar effect to CMF on disease-free and OS. No significant interactions were demonstrated between treatment modality and hormone receptor content, age, or any of the well-known prognostic factors.
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| 17. |
- Kochar, Bharati, et al.
(författare)
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Prevalence and Implications of Frailty in Older Adults With Incident Inflammatory Bowel Diseases : A Nationwide Cohort Study
- 2022
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 20:10, s. 2358-2365
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: We aimed to compare the risk of frailty in older adults with incident inflammatory bowel disease (IBD) and matched non-IBD comparators and assess the association between frailty and future hospitalizations and mortality.Methods: In a cohort of patients with incident IBD ≥60 years of age from 2007 to 2016 in Sweden identified using nationwide registers, we defined frailty using Hospital Frailty Risk Score. We compared prevalence of frailty in patients with IBD with age, sex, place of residency– and calendar year–matched population comparators. In the IBD cohort, we used Cox proportional hazards modeling to examine the associations between frailty risk and hospitalizations or mortality.Results: We identified 10,590 patients with IBD, 52% female with a mean age of 71 years of age, matched to 103,398 population-based comparators. Among patients with IBD, 39% had no risk for frailty, 49% had low risk for frailty, and 12% had higher risk for frailty. Mean Hospital Frailty Risk Score was 1.9 in IBD and 0.9 in matched comparators (P < .01). Older adults with IBD at higher risk for frailty had a 20% greater risk for mortality at 3 years compared with those who were not frail. Compared with nonfrail older patients with IBD, patients at higher risk for frailty had increased mortality (hazard ratio [HR], 3.22, 95% confidence interval [CI], 2.86–3.61), all-cause hospitalization (HR, 2.42; 95% CI, 2.24–2.61), and IBD-related hospitalization (HR, 1.50; 95% CI, 1.35–1.66). These associations were not attenuated after adjusting for comorbidities.Conclusions: Frailty is more prevalent in older adults with IBD than in matched comparators. Among older patients with IBD, frailty is associated with increased risk for hospitalizations and mortality.
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