title: Patients with ulcerative colitis miss more days of work than the general population, even following colectomy.
abstract: OBJECTIVE
  It is unclear whether colectomy restores the ability of patients with ulcerative colitis (UC) to work to precolectomy levels. We estimated the burden of sick leave and disability pension in a population-based cohort of patients with UC and the effects of colectomy.
  
  
  METHODS
  We performed a register-based cohort study using the Swedish National Patient Register and identified working-age patients with UC in 2005 (n = 19,714) and patients who underwent colectomies between 1998 and 2002 (n = 807). Sick leave and disability pension data were retrieved from Statistics Sweden (1995-2005). Data from each patient in the study were compared with those from 5 age-, sex-, education-, and county-matched individuals from the general population.
  
  
  RESULTS
  In 2005, 15% of patients with prevalent UC received a disability pension, compared with 11% of the general population, and 21% vs 13% had ≥1 sick leave episode (P < .001 for each comparison). The annual median work days lost was 0 in both groups, but patients with UC had higher mean (65 vs 45 days; difference, 20; 95% confidence interval [CI], 18-22 days) and 75th percentile work days lost (37 vs 0 days; difference, 37; 95% CI, 36-38 days). Among patients who underwent colectomies, annual days lost increased from a mean of 40 (median, 0) days 3 years before surgery to 141 (median, 99) days during the year of surgery (P < .001). The number then decreased to a mean of 85 days 3 years after surgery (median, 0). The corresponding 75th percentile days were 17, 207, and 130, respectively. Three years after colectomy, 12% did not work at all compared with 7.2% of the general population (risk difference, 5.2%; 95% CI, 2.7%-7.7%) and compared with 5.9% 3 years before colectomy (P < .001).
  
  
  CONCLUSIONS
  Patients with UC miss more work days than the general population in Sweden. Although most patients had no registered work loss 3 years after colectomy, work loss was not restored to presurgery or general population levels in the group that underwent colectomy during several years of follow-up.
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. martin.neovius@ki.se
authors.forename: Martin
authors.initials: M
authors.lastname: Neovius
authors.forename: Elizabeth V
authors.initials: EV
authors.lastname: Arkema
authors.forename: Paul
authors.initials: P
authors.lastname: Blomqvist
authors.forename: Anders
authors.initials: A
authors.lastname: Ekbom
authors.forename: Karin E
authors.initials: KE
authors.lastname: Smedby
mesh_terms: D000328:Adult; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000453:epidemiology* / Q000601:surgery*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010415:Pensions / Q000706:statistics & numerical data*; D012042:Registries; D062707:Return to Work / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult