Mortality in Eosinophilic Esophagitis – a nationwide, population-based matched cohort study from 2005 to 2017

  • Lovisa Röjler Department of Pediatrics, Örebro University Hospital, Sweden
  • John J. Garber Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
  • Bjorn Roelstraete Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  • Marjorie M. Walker Department Anatomical Pathology University of Newcastle Faculty of Health and Medicine School of Medicine and Public Health Callaghan, NSW, Australia
  • Jonas F. Ludvigsson Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, UK; and Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA
Keywords: death, cancer, eosinophilic esophagitis, mortality, population-based


Background: There is a lack of knowledge about mortality in eosinophilic esophagitis (EoE). Therefore, this study aimed to examine the mortality in EoE.

Methods: A nationwide, population-based matched cohort study was conducted of all EoE patients in Sweden diagnosed between July 2005 and December 2017. Individuals with EoE (n = 1,625) were identified through prospectively recorded histopathology codes from all gastrointestinal pathology reports in Sweden, representing 28 pathology departments (the ESPRESSO study). Each individual with EoE was then matched with up to five reference individuals from the general population (n = 8,003) for age, sex, year of birth, and place of residence. We used the Cox proportional hazard modeling to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (95% CI) while adjusting for other potential confounders. In sensitivity analyses, mortality in EoE patients was compared with mortality in their siblings.

Results: Through December 2017, 34 deaths were confirmed in EoE patients (4.60 per 1,000 person-years) compared with 165 in reference individuals (4.57 per 1,000 person-years). This rate corresponds to an aHR of 0.97 (95% CI = 0.67–1.40). HRs were similar in males (aHR = 1.00 [0.66–1.51]) and females (aHR = 0.92 [0.38–2.18]). We observed no increased risk in mortality due to esophageal or other gastrointestinal cancers in patients with EoE (aHR = 1.02 [0.51–2.02]).

Mortality was similar in EoE patients and their siblings (aHR = 0.91 [0.44–1.85]).

Conclusion: In this nationwide, population-based matched cohort study in Sweden, there was no increased risk of death in patients with EoE compared with their siblings and the general population.


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How to Cite
Röjler, L., Garber, J. J., Roelstraete, B., Walker, M. M., & Ludvigsson, J. F. (2021). Mortality in Eosinophilic Esophagitis – a nationwide, population-based matched cohort study from 2005 to 2017. Upsala Journal of Medical Sciences, 126(1).
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