{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T13:18:30Z","timestamp":1791119910810,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Paediatric\u2010onset immune\u2010mediated inflammatory diseases (pIMID) show more aggressive phenotypes than when diagnosed in adults. However, data on mortality are often extrapolated from adult studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To estimate the effect of pIMID on mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a population\u2010based cohort study using the nationwide Danish healthcare registers, we included all patients diagnosed with pIMID in Denmark from 1980 to 2018. PIMID were defined as ICD codes indicative of autoimmune hepatitis, primary sclerosing cholangitis, Crohn's disease, ulcerative colitis, juvenile idiopathic arthritis, lupus erythematosus, or vasculitis registered before age 18\u2009years. All\u2010cause mortality was the primary outcome; cause\u2010specific mortality was the secondary outcome. We used Cox survival analysis to estimate hazard ratios (HR), and Aalen survival analysis to estimate rate differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 11,581 individuals diagnosed with pIMID and 99,665 reference individuals, accounting for 1,371,994 person\u2010years of follow\u2010up. Median and interquartile (IQR) age at diagnosis was 12.6 (7.9\u201315.9) years. During follow\u2010up, 152 patients with pIMID and 316 reference individuals died; adjusted HR (aHR) was 3.8 (95% confidence interval [CI] 3.1\u20134.7). This corresponded to 6.9 (95% CI: 5.3\u20138.5) additional deaths per 10,000 person\u2010years. The strongest associations were found for gastrointestinal diseases (aHR 22.8; 95% CI 9.6\u201364.1), gastrointestinal cancers (aHR 19.2; 95% CI 5.0\u201374.2) and lymphoproliferative disorders (aHR 6.8; 95% CI 2.8\u201316.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients diagnosed with pIMID have a fourfold higher risk of mortality when followed into early adulthood compared with reference individuals. This underlines the severe disease course of pIMID and highlights the need for multidisciplinary care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17994","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T11:54:41Z","timestamp":1712750081000},"page":"1551-1558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Paediatric\u2010onset <scp>immune\u2010mediated<\/scp> inflammatory disease is associated with an increased mortality risk\u2014A nationwide study"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6956-7676","authenticated-orcid":false,"given":"Mikkel","family":"Malham","sequence":"first","affiliation":[{"name":"Department of Paediatric and Adolescence Medicine Copenhagen University Hospital\u2014Amager and Hvidovre  Hvidovre Denmark"},{"name":"Copenhagen Centre for Inflammatory Bowel Disease in Children, Adolescents, and Adults Copenhagen University Hospital\u2014Amager and Hvidovre  Hvidovre Denmark"},{"name":"Section of Epidemiology, Department of Public Health University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Epidemiology Boston University School of Public Health  Boston Massachusetts USA"},{"name":"Department of Global Health Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Jansson","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescence Medicine Copenhagen University Hospital\u2014Amager and Hvidovre  Hvidovre Denmark"},{"name":"Copenhagen Centre for Inflammatory Bowel Disease in Children, Adolescents, and Adults Copenhagen University Hospital\u2014Amager and Hvidovre  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Ingels","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescence 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