Chung C P, Sokka T, Arbogast P G, Pincus T
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-4500, USA.
Ann Rheum Dis. 2006 Dec;65(12):1653-7. doi: 10.1136/ard.2005.048439. Epub 2006 Jun 1.
To analyse and compare work disability attributed to rheumatoid arthritis in two cohorts of patients with early disease: one in the US and the other in Finland.
Two cohorts of patients who were working and aged <65 years at the time of their first symptom of rheumatoid arthritis were studied: 269 patients in Nashville, TN, USA (median age 46 years, 72.5% females), and 364 patients from Jyväskylä, Finland, (median age 47.1 years, 70.9% females). The cohorts were analysed and compared for measures of clinical status and work disability status over a median (interquartile range) of 38.9 months in Nashville and 48.4 months in Jyväskylä.
The probability of working at 36 months was 0.89 (0.84-0.92) for patients from Nashville and 0.84 (0.80-0.88) for patients from Jyväskylä (p = 0.02). These rates were lower than in earlier decades. Patients from Jyväskylä had significantly higher rates of work disability (p = 0.02) than those from Nashville, but better scores for self-report physical function (p<0.001), pain (p<0.001) and global status (p<0.001) at last observation. The likelihood of being disabled from work was 2.6-fold higher in Jyväskylä compared to Nashville (95% confidence interval 1.44 to 4.59, p = 0.001), after adjustment for demographic and disease-specific variables.
Rates of work disability in both early rheumatoid arthritis cohorts were improved from earlier decades, but differed significantly in two different social systems. Higher work disability rates with better clinical status was seen in the Finnish early rheumatoid arthritis cohort than in the US cohort.
分析和比较两组早期类风湿关节炎患者中因该病导致的工作残疾情况，一组在美国，另一组在芬兰。
对两组在出现类风湿关节炎首发症状时正在工作且年龄小于65岁的患者进行研究：美国田纳西州纳什维尔的269例患者（中位年龄46岁，72.5%为女性），以及芬兰于韦斯屈莱的364例患者（中位年龄47.1岁，70.9%为女性）。对两组患者在纳什维尔的中位（四分位间距）38.9个月以及于韦斯屈莱的48.4个月期间的临床状况和工作残疾状况指标进行分析和比较。
纳什维尔患者在36个月时仍在工作的概率为0.89（0.84 - 0.92），于韦斯屈莱患者为0.84（0.80 - 0.88）（p = 0.02）。这些比率低于前几十年。于韦斯屈莱的患者工作残疾率显著高于纳什维尔的患者（p = 0.02），但在最后一次观察时，自我报告的身体功能（p<0.001）、疼痛（p<0.001）和整体状况（p<0.001）得分更高。在对人口统计学和疾病特异性变量进行调整后，于韦斯屈莱因工作而残疾的可能性比纳什维尔高2.6倍（95%置信区间1.44至4.59，p = 0.001）。
两个早期类风湿关节炎队列的工作残疾率较前几十年有所改善，但在两种不同的社会体系中存在显著差异。芬兰早期类风湿关节炎队列的工作残疾率较高，但临床状况优于美国队列。
