title: Predictors of temporary and permanent work disability in patients with inflammatory bowel disease: results of the swiss inflammatory bowel disease cohort study.
abstract: BACKGROUND
  Inflammatory bowel disease can decrease the quality of life and induce work disability. We sought to (1) identify and quantify the predictors of disease-specific work disability in patients with inflammatory bowel disease and (2) assess the suitability of using cross-sectional data to predict future outcomes, using the Swiss Inflammatory Bowel Disease Cohort Study data.
  
  
  METHODS
  A total of 1187 patients were enrolled and followed up for an average of 13 months. Predictors included patient and disease characteristics and drug utilization. Potential predictors were identified through an expert panel and published literature. We estimated adjusted effect estimates with 95% confidence intervals using logistic and zero-inflated Poisson regression.
  
  
  RESULTS
  Overall, 699 (58.9%) experienced Crohn's disease and 488 (41.1%) had ulcerative colitis. Most important predictors for temporary work disability in patients with Crohn's disease included gender, disease duration, disease activity, C-reactive protein level, smoking, depressive symptoms, fistulas, extraintestinal manifestations, and the use of immunosuppressants/steroids. Temporary work disability in patients with ulcerative colitis was associated with age, disease duration, disease activity, and the use of steroids/antibiotics. In all patients, disease activity emerged as the only predictor of permanent work disability. Comparing data at enrollment versus follow-up yielded substantial differences regarding disability and predictors, with follow-up data showing greater predictor effects.
  
  
  CONCLUSIONS
  We identified predictors of work disability in patients with Crohn's disease and ulcerative colitis. Our findings can help in forecasting these disease courses and guide the choice of appropriate measures to prevent adverse outcomes. Comparing cross-sectional and longitudinal data showed that the conduction of cohort studies is inevitable for the examination of disability.
authors: Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria. public-health@umit.at
authors: Uwe
authors: U
authors: Siebert
authors: Johannes
authors: J
authors: Wurm
authors: Raffaella Matteucci
authors: RM
authors: Gothe
authors: Marjan
authors: M
authors: Arvandi
authors: Stephan R
authors: SR
authors: Vavricka
authors: Roland
authors: R
authors: von Känel
authors: Stefan
authors: S
authors: Begré
authors: Michael C
authors: MC
authors: Sulz
authors: Christa
authors: C
authors: Meyenberger
authors: Markus
authors: M
authors: Sagmeister
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013557:Switzerland / Q000453:epidemiology; D014938:Work Capacity Evaluation