title: Permanent work disability in Crohn's disease.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors: Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
authors: Ashwin N
authors: AN
authors: Ananthakrishnan
authors: Lydia R
authors: LR
authors: Weber
authors: Josh F
authors: JF
authors: Knox
authors: Susan
authors: S
authors: Skaros
authors: Jeanne
authors: J
authors: Emmons
authors: Sarah
authors: S
authors: Lundeen
authors: Mazen
authors: M
authors: Issa
authors: Mary F
authors: MF
authors: Otterson
authors: David G
authors: DG
authors: Binion
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014922:Wisconsin / Q000453:epidemiology