Histologic activity in inflammatory bowel disease and risk of serious infections: A nationwide study

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Histologic activity in inflammatory bowel disease and risk of serious infections : A nationwide study

Mårild, Karl, 1982 (författare): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics

Söderling, Jonas (författare): Karolinska Institutet,Karolinska Institutet, Solna, Sweden

Axelrad, Jordan (författare): Inflammatory Bowel Disease Center at NYU Langone Health, Division of Gastroenterology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA,Inflammatory Bowel Disease Center at New York University Langone Health, Division of Gastroenterology, Department of Medicine, New York University Grossman School of Medicine, New York, New York,New York University, USA

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Halfvarson, Jonas, 1970- (författare): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

Forss, Anders (författare): Karolinska Institutet,Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden

Olén, Ola (författare): Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm South General Hospital, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Ludvigsson, Jonas F., 1969- (författare): Karolinska Institutet,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York

Olsson, Malin (författare): Linköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,SWIBREG Study Group

Myrelid, Pär, 1970- (författare): Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,SWIBREG Study Group

Hjortswang, Henrik, 1966- (författare): Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken,SWIBREG Study Group

Bengtsson, Jonas (författare): Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden

Strid, Hans (författare): Department of medicine Solna, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden

Andersson, Marie (författare): Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden

Jäghult, Susanna (författare): Stockholm Gastro Center, Karolinska Institutet, Stockholm, Sweden

Eberhardson, Michael (författare): Department of Gastroenterology, County Council of Östergötland and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

Nordenvall, Caroline (författare): Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Colorectal Cancer Karolinska University Hospital, Stockholm, Sweden

Björk, Jan (författare): Department of medicine Solna, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden

Rejler, Martin (författare): Jönköping University,The Jönköping Academy for Improvement of Health and Welfare

Grip, Olof (författare): Department of Gastroenterology, Skåne University Hospital, Malmö, Sweden

Fagerberg, Ulrika L. (författare): Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden

Karling, Pontus (författare): Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

SWIBREG Study Group, - (bidragsgivare)

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Elsevier, 2024
2024
Engelska.
Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 22:4, s. 831-846

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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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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Gastroenterologi

Artiklar i publikationen: Clinical Gastroe ...

Av lärosätet: Örebro universitet; Jönköping University; Karolinska Institutet; Linköpings universitet; Göteborgs universitet

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Histologic activity in inflammatory bowel disease and risk of serious infections : A nationwide study

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