Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Predictors of Work Disability During the First 3 Years After Diagnosis in a National Rheumatoid Arthritis Inception Cohort.
Olofsson1, Tor, Petersson2, Ingemar F., Eriksson3, Jonas, Englund4, Martin, Simard3, Julia F., Geborek1, Pierre, Jacobsson5, Lennart TH
Dept of Clinical Sciences Lund, Section of Rheumatology, Lund University, Lund, Sweden
Musculoskeletal Sciences, Dept of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden
Clinical Epidemiology Unit, Dept of Medicine, Karolinska Institutet, Stockholm, Stockholm, Sweden
Lund University, Lund, Sweden
Section of Rheumatology, Malmo, Sweden
To estimate predictors of sick leave and disability pension during the 3y period after diagnosis with early RA 19992007 in Sweden.
Individuals aged 1959y diagnosed with early RA were identified in the Swedish Rheumatology Quality Register (19992007; n=3029; mean age 47y; 73% women). Baseline predictors of cumulative days of sick leave and disability pension during the 3y period after RA diagnosis were calculated using linear regression, retrieving days of sick leave and disability pension from the National Social Insurance Agency register covering all inhabitants in Sweden. Due to effect modification by baseline work ability, multivariable analyses were stratified into 3 categories: full=0 days of sick leave and disability pension the month before diagnosis; partial=129 days and none=30 days.
In unadjusted analysis, there were large differences between categories of each predictor regarding cumulative days of sick leave and disability pension during the 3 years following RA diagnosis (Figure). In adjusted multivariable analysis, baseline levels of HAQ, DAS28, VAS global, VAS pain and tender joint count as well as age, education level and unemployment status were significant predictors of cumulative days during the 3y period, when stratifying for baseline work ability. Generally, the largest regression coefficients were seen for the subgroup with partial work ability at baseline and the smallest for the group with full work ability. A one-unit higher HAQ score was associated with 49 additional days off work (p<0.001) if having full work ability at baseline, 134 days (p<0.001) if having partial work ability and 112 days (p<0.001) if having no work ability. The corresponding coefficients for a one-unit higher DAS28 at baseline were 18 (p<0.001), 47 (p<0.001) and 30 days (p=0.006). A 10-year higher age at diagnosis was associated with 20 additional days off work (p<0.001) if having full work ability at baseline, 83 days (p<0.001) if having partial work ability and 77 days (p<0.001) if having no work ability. For education level (comparing <=9 to >12 years) the corresponding coefficients were 79 (p<0.001), 159 (p<0.001) and 86 days (p=0.03).
The baseline level of work ability was strongly associated with total days of sick leave and disability pension during the 3y period after RA diagnosis. Taking this into account, modifiable disease variables such as HAQ and DAS28, as well as age and education level, were also significant predictors. The results indicate that interventions have the largest effect in the patient group with partial work ability at diagnosis.
To cite this abstract, please use the following information:
Olofsson, Tor, Petersson, Ingemar F., Eriksson, Jonas, Englund, Martin, Simard, Julia F., Geborek, Pierre, et al; Predictors of Work Disability During the First 3 Years After Diagnosis in a National Rheumatoid Arthritis Inception Cohort. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2515