Subjective expectations regarding longevity and future health:a cross-sectional survey among patients with Crohn’s disease

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Abstract

AimThe aim was to explore the subjective healthexpectations (sHE) of patients with Crohn’s disease(CD) for both the near future and the elderly.MethodA cross-sectional survey was performed in fourgastroenterology centres in Hungary. Consecutive outpa-tients with CD with age≥18 were recruited. Socio-demo-graphic and disease characteristics were recorded and theCrohn’s Disease Activity Index (CDAI), Perianal DiseaseActivity Index, Patients’ Global Assessment (PGA) andcurrent pain visual analogue scale (VAS) were assessed.Subjective life expectancy (sLE) was explored and com-pared to statistical life expectancy. Current health and sHEfor 1 year ahead and for ages 60/70/80/90 were assessedusing the descriptive system of the EQ-5D-3L.ResultsIn all, 206 patients (54.9% men) with a meanage of 34.7 (SD 10.5 years) and disease duration of10.5 (SD 6.3) years were studied. The CDAI score was110.5 (SD 77.0) and 66% were treated by biologicdrugs. Mean current EQ-5D-3L score was 0.80 (SD0.17) and patients expected a 0.05 (SD 0.15) improve-ment within a year (P<0.05). For ages 60/70/80/90,a mean EQ-5D-3L score of 0.59, 0.38, 0.10 and 0.12 respectively was provisioned. Age, current healthstatus, sLE, PGA and pain VAS showed significant cor-relation with both 1-year and older age sHE(P<0.05). Long-term sHE and sLE were negativelyaffected by the presence of extraintestinal manifestationsbut not by previous CD-related surgery.ConclusionPatients with CD expect severe deteriora-tion in health in later life. Given that unrealistic sHEmay affect patients’ current quality of life and healthbehaviour, we encourage physicians to explore and con-sider CD patients’ sHE in clinical care.