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系统性硬化症的工作残疾。

Work disability in systemic sclerosis.

机构信息

Sir Mortimer B. Davis-Jewish General Hospital and McGill University, Quebec, Canada.

出版信息

J Rheumatol. 2009 Nov;36(11):2481-6. doi: 10.3899/jrheum.081237. Epub 2009 Oct 1.

Abstract

OBJECTIVE

Systemic sclerosis (SSc) is a multisystem disease associated with significant morbidity and increased mortality. Little is known about work disability in SSc. We undertook this study to determine the prevalence and demographic and clinical correlates of work disability in a large cohort of patients with SSc.

METHODS

Cross-sectional, multicenter study of patients from the Canadian Scleroderma Research Group Registry. Patients were assessed with detailed clinical histories, medical examinations, and self-administered questionnaires. The primary outcome was self-reported work disability. Multiple logistic regression was used to assess the relationship between selected demographic and clinical variables and work disability.

RESULTS

Of the 643 patients available for this study, 133 (21%) reported that they were work disabled. Work disability in SSc was common, even in people with short disease duration, and increased steadily with increasing disease duration: among those who were <or= 65 years and who reported being either disabled or working, 28.0% and 44.8% of patients with disease duration of < 2 and 10-15 years, respectively, reported that they were work-disabled. The significant correlates of work disability included co-morbidities, disease duration, diffuse disease, disease severity, pain, fatigue, and physical function.

CONCLUSION

Work disability is prevalent, occurs early, and is associated with markers of disease severity and functional status. Further research is needed to identify other, potentially modifiable, risk factors for work disability in SSc.

摘要

目的

系统性硬化症(SSc)是一种多系统疾病,与较高的发病率和死亡率相关。对于 SSc 患者的工作能力丧失情况知之甚少。我们开展了这项研究,旨在确定大型 SSc 患者队列中工作能力丧失的患病率及其与人口统计学和临床特征的关系。

方法

这是一项来自加拿大硬皮病研究组注册中心的横断面、多中心研究,对患者进行详细的临床病史、体格检查和自我管理问卷评估。主要结局是自我报告的工作能力丧失。采用多因素逻辑回归分析评估选定的人口统计学和临床变量与工作能力丧失之间的关系。

结果

本研究纳入 643 例患者,其中 133 例(21%)报告存在工作能力丧失。SSc 患者的工作能力丧失较为常见,即使在疾病持续时间较短的患者中也是如此,且随着疾病持续时间的增加而逐渐增加:在年龄≤65 岁且报告残疾或工作的患者中,分别有 28.0%和 44.8%的患者疾病持续时间<2 年和 10-15 年的患者报告工作能力丧失。工作能力丧失的显著相关因素包括合并症、疾病持续时间、弥漫性疾病、疾病严重程度、疼痛、疲劳和身体功能。

结论

工作能力丧失较为普遍,发病较早,与疾病严重程度和功能状态的标志物相关。需要进一步研究以确定 SSc 患者工作能力丧失的其他潜在可改变的危险因素。

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