P687 Work disability in IBD: prevalence, severity and predictive factors.
R.-R. Huascar A.*1, C. Xavier2, S. Beatriz3, V. Mercedes4, F. Ariadna5, G. Fernando6
1Universitary Hospital of Burgos, Gastroenterology and hepatology, Burgos, Spain, 2Corporació sanitaria universitaria Parc Taulí, Servei aparell digestiu, Sabadel, Spain, 3Hospital Universitary of Burgos, Gastroenterology and Hepatology, Burgos, Spain, 4InstituTO de Salud Carlos III, Gastroenterology, Madrid, Spain, 5Fundación Universitaria de Bages, Gastroenterology, Barcelona, Spain, 6Hospital clínico universitario de Zaragoza, Gastroenterologia, Zaragoza, Spain
Patients with inflammatory bowel disease (IBD) may develop work disability. However, data on disability's true prevalence are scarce. The aim of the present study was to evaluate the prevalence and severity of disability and its predicting factors in a well-characterized community-based IBD population.
All patients included in the community-based IBD register of the Complejo Asistencial de Burgos were contacted. After full information, the patients gave signed informed consent and fulfilled a set of standardized questionnaires including demographic data, data on the characteristics and activity of disease and whether they have a recognized degree of disability and/or a disability grant. In addition, the patients fulfilled the IBDQ-9 and EuroQol questionnaires for quality of life. Statistical analysis was performed using SPSS 21 (IBM Corporation, Chicago, IL).
Two hundred ninety-two patients -151 Crohn's diseases (CD), 141 ulcerative colitis (UC), 137 female, mean age: 45 ± 11 years) were included in the study. Mean time from the diagnosis of IBD was 10.6 ± 11 years. Most patients were in remission or had moderate symptoms at inclusion. Harvey-Bradshaw and modified Mayo score were 4.1 and 2.2 for CD and UC respectively. Fifty percent were on immunosuppressant drugs (mainly thiopurines) and 15% received anti-TNF. Twelve patients (6.1%) had a work- disability grant; eight of them (2.7%) were considered to be unable to perform any kind of work. In all but two the main cause of the disability was exclusively the IBD. In addition, the Spanish National Health Service acknowledged a certain degree of disability to 93 (32%) patients. Over a 100% scale, 73 (26%) had a moderate disability degree (mayor or equal 33%-<55%) and 16 (6%) a severe disability (mayor or equal 55%). Univariate analysis showed that age and time of evolution of the disease, having CD, perianal disease, incontinence, the use of an anti-TNF drug, having one o more surgeries or intestinal resections and having an ostomy were the major predictors of having any degree of disability. For severe disease requiring a disability grant, major predictors were having extensive disease, incontinence, use of a biological drug, previous surgery or resection and ostomy.
Work disability is frequent in IBD although only a minority develops severe disability requiring a pension. Disability increases with the time of evolution of the disease. Major sources of disability are persistent activity of the disease and surgical long-term complications.