Meds 2010, School of Medicine, Queen's University, Kingston, Ontario, Canada.
Lupus. 2009 Dec;18(14):1281-8. doi: 10.1177/0961203309345784. Epub 2009 Oct 23.
Our objectives were to examine the prevalence of work disability (WD) and factors associated with job loss in systemic lupus erythematosus (SLE) in a large, multi-centered Canadian sample to determine the current prevalence of WD and identify the contribution of disease activity, damage, and co-morbidities with respect to WD in this cohort. Cross-sectional data on WD status from the 1000 Canadian Faces of Lupus database (a multi-center multi-ethnic cohort of SLE patients) along with clinical measures (number of ACR criteria ever, SLICC Damage Index, SLAM, SLEDAI, SF-36 and Charlson Co-morbidity Index scores), demographic features (age, sex, high school education, household income, marital status, disease duration, employment status) and co-morbidities (including self-reported fibromyalgia, arthralgias, depression and fatigue) were used in bivariate and logistic regression analyses. The 1137 SLE patients had a mean age of 50 years (SE 0.75) and mean disease duration was 18 years (SE 0.70); 19.09% were work disabled and 49.78% were employed. Those with WD were more likely than non-WD SLE patients to have: a higher number of ACR criteria for SLE; not completed high school; older age; single marital status; a lower household income; longer disease duration; higher SLICC Damage Index and SLAM scores; lower SF-36 PCS and SF-36 MCS scores; less vigorous activity per week; and fibromyalgia, arthralgias, fatigue and depression (p < 0.05). This contemporary rate of WD is lower than many past reports. Socio-demographic factors, co-morbidities (fibromyalgia and fatigue) and disease related factors were strongly associated with WD. We cannot determine cause and effect as the study was cross-sectional.
我们的目的是在一个大型的、多中心的加拿大样本中检查系统性红斑狼疮（SLE）患者的工作残疾（WD）患病率和与失业相关的因素，以确定当前 WD 的患病率，并确定在该队列中疾病活动度、损伤和合并症对 WD 的贡献。来自 1000 名加拿大狼疮面孔数据库（一个多中心多民族 SLE 患者队列）的 WD 状态的横断面数据，以及临床指标（ACR 标准的数量、SLICC 损伤指数、SLAM、SLEDAI、SF-36 和 Charlson 合并症指数评分）、人口统计学特征（年龄、性别、高中教育、家庭收入、婚姻状况、疾病持续时间、就业状况）和合并症（包括自我报告的纤维肌痛、关节痛、抑郁和疲劳）用于单变量和逻辑回归分析。1137 例 SLE 患者的平均年龄为 50 岁（SE 0.75），平均疾病持续时间为 18 年（SE 0.70）；19.09%的患者工作残疾，49.78%的患者就业。与非 WD SLE 患者相比，WD 患者更有可能：有更多的 SLE ACR 标准；未完成高中学业；年龄较大；单身婚姻状况；家庭收入较低；疾病持续时间较长；SLICC 损伤指数和 SLAM 评分较高；SF-36 PCS 和 SF-36 MCS 评分较低；每周活动量较少；纤维肌痛、关节痛、疲劳和抑郁（p<0.05）。这种当代 WD 的发生率低于许多过去的报告。社会人口统计学因素、合并症（纤维肌痛和疲劳）和疾病相关因素与 WD 密切相关。由于研究是横断面的，我们无法确定因果关系。
