Work disability in patients with inflammatory bowel diseases. preliminary report from two referral centers

Abstract

Background & aims: To compare the work disability (WD) rate in inflammatory bowel disease (IBD) patients, with the WD rate in the background population, and to assess whether clinical or demographic factors are associated with WD. Methods: Data of 210 (male/female 91/119, CD/UC: 129/81, median age at onset: 24.5 years, duration:9.5) consecutive patients with at least one-year disease duration were included. WD data were collected by questionnaire. Data on disability pension (DP) in the background population were retrieved from public databases (ONYF). We calculated overall and age-standardised relative risks (RR) for DP. Logistic regression analysis was used to examine predictive factors. Results: The overall disability rate in this referral population was 37.6% with partial disability in 28.1%. Overall, WD was more prevalent in IBD (RR: 1.79, 95% CI: 1.18 – 2.72; in Crohn's disease RR: 2.10, 95% CI: 1.31 – 3.39 and in ulcerative colitis RR: 1.35, 95% CI: 0.62 – 2.90) compared to the background population. The DP rate increase gradually parallel with the age groups (from 22.2% in the < 35-year-olds to 65% in the 50 – 62-year olds). The RR was highest in patients with an age < 35 years and 35 – 40-years (RR: 13.9 and 9.1), while patients > 50 years had no increased RR. Previous surgery/colectomy (OR: 6.42, 95% CI: 2.37 – 17.3) and long disease duration (OR: 4.35, 95% CI: 1.43 – 13.3) but not exposure to steroids, need for azathioprine or biological were associated with an increased risk for DP. Conclusions: IBD patients are at increased risk for DP as compared with the background population. The youngest patients had the highest risk. Previous surgery was identified as risk factor for DP.