RESEARCH - Factors associated with permanent work disability in Mexican patients with RA

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J Rheumatol. 2006 Jul;33(7):1247-1249. Epub 2006 Jun 1.

Factors Associated with Permanent Work Disability in Mexican Patients with

Rheumatoid Arthritis. A Case-Control Study.

Morales-Romero J, - L, Celis A, -Arreola BE,

Cabrera-Pivaral CE, Gamez-Nava JI.

From the Department of Internal MedicineRheumatology, Hospital General

Regional 110, IMSS; and Department of Public Health Sciences, Centro

Universitario de Ciencias de la Salud, Universidad de Guadalajara,

Guadalajara, Mexico.

OBJECTIVE: To assess factors associated with permanent work disability (PWD)

in Mexican subjects with rheumatoid arthritis (RA). METHODS: From a database

of 300 salaried workers with RA, we evaluated 35 cases that developed PWD.

These cases were compared with 70 controls randomly selected from the same

database who were active workers. The assessment included the following

variables: sociodemographic, education, employment, and clinical

characteristics of the disease. Logistic regression analysis was performed

to adjust variables associated with PWD. Odds ratios and their 95%

confidence intervals (95% CI) were computed. RESULTS: Factors associated

with PWD in the unadjusted analysis were: lower education level (OR 3.27,

95% CI 1.28-8.49, p = 0.006), >/= 2 year delay in prescription of a disease

modifying antirheumatic drug (DMARD) (OR 4.29, 95% CI 1.49-12.73, p = 0.02),

joint prosthesis (OR 8.93, 95% CI 2.02-45.04, p < 0.001), severe

radiographic damage (OR 3.33, 95% CI 1.20-9.46, p = 0.01), comorbidity (OR

7.54, 95% CI 1.94-34.25, p < 0.001), and positive rheumatoid factor (RF) (OR

3.53, 95% CI 0.98-13.76, p = 0.03). In the multivariate model PWD was

predicted by lower education (OR 3.3, 95% CI 1.1-9.7, p = 0.03), positive RF

(OR 4.9, 95% CI 1.2-19.7, p = 0.03), and delay in the prescription of a

DMARD (OR 3.3, 95% CI 1.1-10.1, p = 0.04).

CONCLUSION: A low education level, positive RF, and delay in the use of

DMARD are risk factors for PWD. Strategies to decrease rates of PWD should

include an earlier treatment with DMARD.

PMID: 16758509

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=16758509

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