Ulcerative colitis impairs work capacity

Patients with ulcerative colitis (UC) have higher rates of sick leave or disability pension than the general population, show findings published in Gastroenterology.

The study also revealed that colectomy does not fully restore work ability to presurgery or general population levels after 3-7 years of follow up. However, approximately half of all patients did not experience any work loss either before or 3 years after surgery.

"This is the largest study on productivity losses in UC patients presented to date, and first longitudinal study on sick leave and disability pension in relation to colectomy," say Martin Neovius (Karolinska Institute, Stockholm, Sweden) and colleagues.

Using the Swedish National Patient Register, the researchers identified 19,714 working-age UC patients in 2005, and 807 patients who received colectomies during 1998-2005. Data for each patient were compared with those obtained from five age-, gender-, education- and county-matched individuals from the general Swedish population.

This comparison revealed that significantly more UC patients than controls received disability pension (15 vs 11%) and had at least one registered sick-leave episode (21 vs 13%) in 2005.

UC patients lost an average 20 more work days per year, but no difference was seen in the median number of days lost, reflecting that at least 50% of individuals in both groups were working.

Factors predictive for loss of work days included higher age, lower education, female gender, and comorbidities (chronic obstructive pulmonary disease, cardiovascular disease, depression, and malignancy).

The researchers say that colectomy may have social as well as psychologic consequences, both of which increase work loss. Furthermore, identified comorbidities were found to be responsible for some of the work loss differences seen between patients and the general population.

Among the 807 UC patients who received a colectomy and were followed up for up to 7 years, the annual days lost increased from an average 40 days at 3 years before surgery to 141 during the surgery year. This number then decreased to 85 days after 3 years of follow up.

However, a significantly greater proportion of post-colectomy patients did not work at all, compared with the general population, 3 years after the procedure (12.0 vs 7.2%).

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