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Patients with Ulcerative Colitis Miss More Days of Work than the General Population, Even following Colectomy.
MedLine Citation:
PMID:  23232295     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND & AIMS:: It is unclear whether colectomy restores the ability of patients with ulcerative colitis (UC) to work to pre-colectomy 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 that received 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 prevalent UC patients were on a disability pension, compared with 11% in 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 the UC patients had higher mean (65 vs 45 days; difference 20, 95% CI, 18-22 days) and 75th percentile work days lost (37 vs 0 days; difference 37, 95% CI, 36-38 days). Among patients that received colectomies, annual days lost increased from mean 40 (median 0) days 3 years before surgery to 141 (99) days during the surgery year (P<.001). The number then decreased to a mean of 85 days at 3 years after surgery (median 0). The corresponding 75th percentile days were 17, 207 and 130. Three years post 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. CONCLUSION:: 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, in the group that underwent colectomy, work loss was not restored to pre-surgery or general population levels during several years of follow-up.
Authors:
Martin Neovius; Elizabeth V Arkema; Paul Blomqvist; Anders Ekbom; Karin E Smedby
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-8
Journal Detail:
Title:  Gastroenterology     Volume:  -     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Clinical Epidemiology Unit, Dept of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address: martin.neovius@ki.se.
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