Employment status and socio-economic burden in systemic sclerosis: a cross-sectional survey.
OBJECTIVE
To assess employment status and socio-economic burden in SSc patients.


METHODS
Eighty-seven SSc patients (72 females), fulfilling the ACR or the Leroy and Medsger criteria, or both, were evaluated for employment status, socio-economic burden and handicap. Statistical analysis involved Mann-Whitney U-test and Fisher's exact test and backward stepwise regression analysis.


RESULTS
In total, 60.9% of the SSc patients were on full-time sick leave and 35.6% were receiving a disability pension. On univariate analysis, myalgia was the only clinical manifestation more frequently encountered in sick-leave patients than others (73.6 vs 47.1%; P = 0.012). Karnofsky performance status (KPS) was lower in SSc patients who were on sick leave or were receiving a disability pension than others [78.5 (10.6) vs 85.8 (9.0); P = 0.004 and 78.1 (8.7) vs 83.1 (11.2); P = 0.016, respectively]. In addition, greater global, hand and mouth handicaps and depression were observed in patients on sick leave [HAQ 0.9 (0.7) vs 0.6 (0.5); P = 0.021; Cochin Hand Function Scale 21.7 (18.9) vs 10.7 (12.1); P = 0.003; mouth handicap scale 20.2 (10.8) vs 14.6 (10.0); P = 0.014; and depression dimension of the hospital anxiety and depression scale 7.1 (3.9) vs 4.8 (3.4); P = 0.003]. On multivariate analysis, factors associated with sick leave were KPS [odds ratio (OR) 0.92; 95%CI 0.88, 0.98] and myalgias (OR 3.19; 95% CI 1.19, 8.58), and the factor associated with receiving a disability pension was decreased income (OR 8.19; 95% CI 2.67, 25.12).


CONCLUSIONS
SSc patients commonly have to take full-time sick leave from work. Despite such patients receiving disability pensions, the socio-economic burden is considerable.
Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Paris, France.
Christelle
C
Nguyen
Serge
S
Poiraudeau
Caroline
C
Mestre-Stanislas
François
F
Rannou
Alice
A
Bérezné
Agathe
A
Papelard
Dominique
D
Choudat
Michel
M
Revel
Loïc
L
Guillevin
Luc
L
Mouthon
D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012595:Scleroderma, Systemic / Q000191:economics* / Q000503:physiopathology / Q000523:psychology; D012720:Severity of Illness Index; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data*; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors