Permanent work disability in Crohn's disease. Am J Gastroenterol 2008 Jan;103(1):154-61
Date
12/14/2007Pubmed ID
18076736DOI
10.1111/j.1572-0241.2007.01561.xScopus ID
2-s2.0-37849012301 (requires institutional sign-in at Scopus site) 87 CitationsAbstract
OBJECTIVE: Crohn's disease (CD) frequently presents during early adulthood, a peak time of work productivity. There are limited data from the United States on work disability from CD. We performed this study to identify clinical factors associated with permanent work disability in a CD tertiary referral cohort.
METHODS: Cases were identified as patients who received permanent work disability compensation from the social security administration (SSA) related to CD. Four control patients who were not receiving work disability were selected for each case. Multivariate logistic regression was performed to identify characteristics that were independently associated with work disability.
RESULTS: A total of 737 patients with CD were seen in our center, and 185 CD patients were included in our study (37 disability cases, 148 controls). On multivariate analysis, an SIBDQ score <or=50 (OR 12.44, 95% CI 4.45-34.79), undergoing two or more GI surgeries (OR 7.09, 95% CI 2.63-19.11), and two or more medical hospitalizations (OR 2.76, 95% CI 1.03-7.37) were significantly associated with work disability in CD. Disease location (small bowel vs colon), type (inflammatory, stricturing, or fistulizing), or specific treatment strategies were not associated with work disability in our analysis.
CONCLUSION: Permanent work disability administered through social security was encountered in 5.3% of the Crohn's patients followed in our cohort. Patients who consistently report low quality of life, or have frequent flares requiring surgical intervention or hospitalization for medical management, may be at risk for CD-related work disability.
Author List
Ananthakrishnan AN, Weber LR, Knox JF, Skaros S, Emmons J, Lundeen S, Issa M, Otterson MF, Binion DGAuthors
Sarah J. Lundeen NP Nurse Practitioner Surgical in the Surgery department at Medical College of WisconsinMary F. Otterson MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultCrohn Disease
Disability Evaluation
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Prevalence
Retrospective Studies
Severity of Illness Index
Wisconsin