Area Editoriale
OBJECTIVES:It remains debated whether patients with ulcerative colitis (UC) are at greaterrisk of dying and whether a possible alteration in mortality can be attributedto specific causes of death. We aimed to clarify this issue by conducting ameta-analysis of population-based inception cohort studies on overall andcause-specific mortality in patients with UC. METHODS: The MEDLINE searchengine and abstracts from international conferences were searched for relevantliterature by use of explicit search criteria. STATA meta-analysis software wasused to calculate pooled risk estimates (SMR, standardized mortality ratio,observed/expected deaths) of overall mortality and specific causes of death andto conduct metaregression analyses of the influence of specific variables onSMR. RESULTS: Ten papers fulfilled the inclusion criteria, reporting SMRsvarying from 0.7 to 1.4. The overall pooled estimate was 1.1 (95% confidenceinterval [CI] 0.9-1.2, P= 0.42). However, greater risk of dying was observedduring the first years of follow-up, in patients with extensive colitis, and inpatients from Scandinavia.Metaregression analysis showed an increase in SMR by increasing cohort size.UC-related mortality accounted for 17% of all deaths. Mortality fromgastrointestinal diseases, nonalcoholic liver diseases, pulmonary embolisms,and respiratory diseases was increased whereas mortality from pulmonary cancerwas reduced. CONCLUSIONS: The overall risk of dying in patients with UC did notdiffer from that of the background population, although subgroups of patientswere at greater risk of dying. The cause-of-death distribution seemed to differfrom that of the background population.Leggil'articolo