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Work Loss Before and After Diagnosis of Crohn's Disease
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Masschusetts, USA.
Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Division of Surgery, Department of Clinical and Experimental Medicine, Faulty of Health Sciences, Linköping University, Linköping, Sweden; Department of Surgery, County Council of Östergötland Linköping, Linköping, Sweden.
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2019 (English)In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 25, no 7, p. 1237-1247Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to examine work loss in patients with Crohn's disease.

Methods: Using nationwide registers, we identified incident patients with Crohn's disease (2007-2010) and population comparator subjects without inflammatory bowel disease, matched by age, sex, calendar year, health care region, and education level. We assessed the number of lost workdays due to sick leave and disability pension from 5 years before to 5 years after first diagnosis of Crohn's disease or end of follow-up (September 30, 2015).

Results: Among the 2015 incident Crohn's disease patients (median age, 35 years; 50% women), both the proportion with work loss and the mean annual number of lost workdays were larger 5 years before diagnosis (25%; mean, 45 days) than in the 10,067 comparators (17%; mean, 29 days). Increased work loss was seen during the year of diagnosis, after which it declined to levels similar to before diagnosis. Of all patients, 75% had no work loss 24-12 months before diagnosis. Of them, 84% had full work ability also 12-24 months after diagnosis. In patients with total work loss (8.3% of all) before diagnosis, 83% did not work after. Among those with full work ability before diagnosis, the absolute risk of having total work loss after diagnosis was 1.4% (0.43% in the comparators). Our results were consistent across several sensitivity analyses using alternative definitions for date of diagnosis.

Conclusions: Patients with Crohn's disease had increased work loss several years before diagnosis, possibly explained by comorbidity or by diagnostic delay.

Place, publisher, year, edition, pages
Oxford University Press, 2019. Vol. 25, no 7, p. 1237-1247
Keywords [en]
Sick leave, disability pension, Crohn’s disease, IBD, diagnostic delay, comorbidity
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-70799DOI: 10.1093/ibd/izy382ISI: 000473764400022PubMedID: 30551185Scopus ID: 2-s2.0-85068378913OAI: oai:DiVA.org:oru-70799DiVA, id: diva2:1271928
Funder
Swedish Research CouncilSwedish Cancer SocietySwedish Heart Lung FoundationSwedish Society of MedicineStockholm County Council
Note

Funding Agencies:

Karolinska Institutet (KI SOS)

Swedish Medical Society (Fund for Research in Gastroenterology)  

Swedish Medical Society (Ihre Foundation)  

Stiftelsen Tornspiran  

Mag-tarmfonden  

Jane and Dan Olsson Foundation  

Mjölkdroppen Foundation  

Bengt Ihre Research Fellowship in Gastroenterology 

Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2019-07-23Bibliographically approved

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Ludvigsson, Jonas F.Halfvarson, Jonas

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