Crohns Disease Disability
09.13.09
Colitis or Crohn’s Disease, NACC has produced a range of different benefit guides relating to incapacity benefit and disability living allowance. Crohns disease (CD) frequently presents during early adulthood, a peak time of work productivity. There are limited data from the United States on work disability from CD. We performed this study to identify clinical factors associated with permanent work disability in a CD tertiary referral cohort.
Methods: Cases were identified as patients who received permanent work disability compensation from the social security administration (SSA) related to CD. Four control patients who were not receiving work disability were selected for each case. Multivariate logistic regression was performed to identify characteristics that were independently associated with work disability.
Results: A total of 737 patients with CD were seen in our center, and 185 CD patients were included in our study (37 disability cases, 148 controls). On multivariate analysis, an SIBDQ score ≤50 (OR 12.44, 95% CI 4.45-34.79), undergoing two or more GI surgeries (OR 7.09, 95% CI 2.63-19.11), and two or more medical hospitalizations (OR 2.76, 95% CI 1.03-7.37) were significantly associated with work disability in CD. Disease location (small bowel vs colon), type (inflammatory, stricturing, or fistulizing), or specific treatment strategies were not associated with work disability in our analysis.
Conclusion: Permanent work disability administered through social security was encountered in 5.3% of the Crohn’s patients followed in our cohort. Patients who consistently report low quality of life, or have frequent flares requiring surgical intervention or hospitalization for medical management, may be at risk for CD-related work disability.
The statistics of the German social security system were used to analyse the epidemiology of inflammatory bowel disease (IBD) in Germany and to assess its impact on disability.
Patients granted disability pension for IBD were compared with a control group of patients disabled from other causes. Crohns disease and ulcerative colitis led to disability in significantly younger patients than other diseases. Disability from Crohns disease was 2.0-fold more common in women than men (95% confidence interval: 1.8-2.3), while disability from ulcerative colitis was similar in both sexes.
White collar employees were affected by both diseases more frequently than blue collar employees, the ratio being 1.3 (1.2-1.5) in Crohns disease and 1.6 (1.4-1.8) in ulcerative colitis. Although IBD is relatively rare, it has severe socioeconomic implications, because compared with other diseases, predominantly young age groups become disabled
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