Eberhardt Kerstin, Larsson Britt-Marie, Nived Kerstin, Lindqvist Elisabet
Department of Rheumatology, Lund University Hospital, Lund, Sweden.
J Rheumatol. 2007 Mar;34(3):481-7. Epub 2007 Feb 1.
To investigate work disability rates over 15 years in an early rheumatoid arthritis (RA) cohort and to evaluate predictive factors during the course of the study.
All patients with early RA of working age (n = 148) were followed and treated at a team care unit. Mean disease duration at inclusion was 1 year. Work characteristics and disease-related variables were recorded annually. Logistic regression analyses were performed to identify predictors for work disability after 5, 10, and 15 years.
Work disability rates were 28%, 35%, 39%, and 44% at study start and after 5, 10, and 15 years, respectively. Forty-seven patients reduced working hours and 34 changed work tasks during the study time. Older age, less education, heavy manual work, and much activity limitation assessed by Health Assessment Questionnaire (HAQ) were predictors of work disability. Demographics and work factors had best predictive value in the early phase, while HAQ was a strong predictor at all points in time. Odds ratios for baseline HAQ, 5 year HAQ, and 10 year HAQ were 6.3, 9.6, and 4.1 for work disability after 5, 10, and 15 years, respectively.
The prevalence of work disability was 28% at inclusion. After 15 years' followup the prevalence was 44%, which is lower than previously reported. HAQ was the single prognostic factor with strong predictive value throughout the study.
调查早期类风湿关节炎（RA）队列15年期间的工作残疾率，并评估研究过程中的预测因素。
所有工作年龄的早期RA患者（n = 148）在一个团队护理单元接受随访和治疗。纳入时的平均病程为1年。每年记录工作特征和疾病相关变量。进行逻辑回归分析以确定5年、10年和15年后工作残疾的预测因素。
在研究开始时以及5年、10年和15年后，工作残疾率分别为28%、35%、39%和44%。在研究期间，47名患者减少了工作时间，34名患者改变了工作任务。年龄较大、受教育程度较低、从事重体力劳动以及通过健康评估问卷（HAQ）评估的活动受限程度较高是工作残疾的预测因素。人口统计学和工作因素在早期阶段具有最佳预测价值，而HAQ在所有时间点都是一个强有力的预测因素。基线HAQ、5年HAQ和10年HAQ对于5年、10年和15年后工作残疾的优势比分别为6.3、9.6和4.1。
纳入时工作残疾的患病率为28%。经过15年的随访，患病率为44%，低于先前报道。HAQ是整个研究中具有强预测价值的单一预后因素。
