Work disability in inflammatory bowel disease patients 10 years after disease onset: results from the IBSEN Study
Work disability in inflammatory bowel disease patients 10 years after disease onset: results from the IBSEN Study
复制标题
DOI：
10.1136/gutjnl-2012-302311
复制
发表时间：
2013-03-01
期刊：
影响因子：
24.5
通讯作者：
Bernklev, Tomm
中科院分区：
文献类型：
--
作者：
Hoivik, Marte Lie;Moum, Bjorn;Bernklev, Tomm
目的比较炎症性肠病（inflammatory bowel disease，IBD）患者发病10年后的工作能力丧失（work disability，WD）率与背景人群的WD率，并评估早期病程中的临床或人口统计学因素是否能预测疾病10年后的WD。在诊断后1年、5年和10年前瞻性随访基于人群的初始队列（挪威东南部炎症性肠病队列）。在10年随访时，收集了WD的数据。从公共数据库中检索背景人口的残疾养恤金数据。我们计算了DP的总体和年龄标准化相对风险（RR）。结果518例患者完成了10年的随访，有效率为83.5%。IBD人群的总体残疾率为18.8%，溃疡性结肠炎（UC）的RR为1.8（95% CI 1.4 - 2.3），克罗恩病（CD）为2.0（95% CI 1.4 - 2.7）。DP的RR在40岁以下的患者中最高，而60岁以上的患者的RR没有增加。在CD和UC患者中，1年随访时的类固醇治疗可预测疾病10年后的WD。在UC，C-反应蛋白（CRP）或红细胞沉降率（ESR）在诊断，早期结肠切除术，并在疾病的第一年超过两次复发也预测WD。结论疾病发作后10年IBD患者有一个增加的RR DP相比，背景人群。最年轻的患者RR最高。严重病程标志物可预测WD。
Objective To compare the work disability (WD) rate in inflammatory bowel disease (IBD) patients 10 years after disease onset, with the WD rate in the background population, and to assess whether clinical or demographic factors in the early disease course could predict WD after 10 years disease.Design A large, population-based inception cohort (the Inflammatory Bowel in South Eastern Norway cohort) was prospectively followed up at 1, 5 and 10 years after diagnosis. At the 10-year follow-up data on WD were collected. Data on disability pension (DP) in the background population were retrieved from public databases. We calculated overall and age-standardised relative risks (RR) for DP. Logistic regression analysis was used to examine predictive factors.Results A total of 518 patients completed the 10-year follow-up (response rate 83.5%). The overall disability rate in the IBD population was 18.8%, and the RR was 1.8 (95% CI 1.4 to 2.3) for ulcerative colitis (UC) and 2.0 (95% CI 1.4 to 2.7) for Crohn's disease (CD). The RR for DP was highest in patients aged below 40 years while patients aged over 60 years had no increased RR. Steroid treatment at the 1-year follow-up predicted WD after 10 years disease in both CD and UC. In UC, increased C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) at diagnosis, early colectomy, and more than two relapses during the first year of the disease also predicted WD.Conclusion Ten years after disease onset IBD patients had an increased RR for DP as compared with the background population. The youngest patients had the highest RR. Markers of severe disease course predicted WD.