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Pediatric inflammatory bowel disease: Increasing incidence, decreasing surgery rate, and compromised nutritional status: A prospective population-based cohort study 2007–2009

Jakobsen, Christian MD1,*; Paerregaard, Anders MD1; Munkholm, Pia MD2; Faerk, Jan MD3; Lange, Aksel MD4; Andersen, Jesper MD5; Jakobsen, Marianne MD6; Kramer, Iza MD7; Czernia-Mazurkiewicz, Janina MD8; Wewer, Vibeke MD1

doi: 10.1002/ibd.21654
Original Article

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 106 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.

1 Department of Pediatrics, Hvidovre University Hospital, Copenhagen, Denmark

2 Department of Gastroenterology, Medical section, Herlev University Hospital, Copenhagen, Denmark

3 Department of Pediatrics, Holbaek Hospital, Holbaek, Denmark

4 Department of Pediatrics, Skejby University Hospital, Aarhus, Denmark

5 Department of Pediatrics, Hilleroed Hospital, Hilleroed, Denmark

6 Department of Pediatrics, Odense University Hospital, Odense, Denmark

7 Department of Pediatrics, Roskilde Hospital, Roskilde, Denmark

8 Department of Pediatrics, Nykoebing Falster Hospital, Nykoebing Falster, Denmark

*Reprints: Hvidovre University Hospital, Kettegaard Alle 30, 2650 Hvidovre, Denmark

Email: Christian.jakobsen@hvh.regionh.dk

Received 13 December 2010; Accepted 23 December 2010

Published online 4 March 2011 in Wiley Online Library (wileyonlinelibrary.com).

Grant sponsor: Copenhagen University; Grant sponsor: Augustinus Foundation; Grant sponsor: Ville Heise Foundation; Grant sponsor: Sigrid Morans Foundation; Grant sponsor: Vibeke Binder and Poul Riis Foundation.

Supported by grants from Copenhagen University, the Augustinus Foundation, Ville Heise Foundation, Sigrid Morans Foundation, and the Vibeke Binder and Poul Riis Foundation.

© Crohn's & Colitis Foundation of America, Inc.
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