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Correlates of Formal Work Disability in an Urban University Systemic Lupus Erythematosus Practice
TAMMY O. UTSET, SAIMA CHOHAN, STEPHANIE A. BOOTH, JANELLE C. LAUGHLIN, MASHA KOCHERGINSKY, and AMANDA SCHMITZ
ABSTRACT. Methods. Ambulatory patients with SLE were enrolled in a cross-sectional study. Data collected by standardized interview, examination, questionnaire, and chart review were compared between formally work-disabled and never-disabled subjects. Multivariate logistic regression with outcome of formal work disability was then performed, using significant variables on univariate analysis. Results. One hundred thirty-two of 143 subjects were working or students at time of SLE diagnosis. After a mean of 9.2 years' disease duration, 42.7% reported formal work disability due to SLE. On univariate analysis, lower education, African American ethnicity, marital status, and high disease activity and damage scores were associated with increased prevalence of work disability. Work type did not affect risk of work disability. Work-disabled subjects had more severe pain, fatigue, depression, and anxiety. On multivariate logistic regression, damage, African American ethnicity, and fatigue were associated with formal work disability, while global pain had a marginal association. Conclusion. Formal work disability was highly prevalent in SLE, occurring in 42.7% of subjects. Disease damage, global pain, and fatigue were independently associated with formal work disability status on multivariate logistic regression. Premorbid work types did not strikingly influence rates of work disability. (First Release May 1 2008; J Rheumatol 2008;35:1046-52) Key Indexing Terms:
WORK From the University of Chicago, Department of Medicine, Section of Rheumatology, and Department of Health Studies; University of Chicago Hospitals, Chicago, Illinois; Seton Health Systems, Austin, Texas; and Longmont United Hospital, Longmont, Colorado, USA. Dr. Utset, Dr. Laughlin, and Ms. Schmitz received grant support from the Lupus Clinical Trials Consortium. T.O. Utset, MD, MPH, Associate Professor of Medicine; S. Chohan, MD, Assistant Professor of Medicine, Department of Medicine, Section of Rheumatology; M. Kocherginsky, PhD, Research Associate, Assistant Professor, Department of Health Studies, University of Chicago; S.A. Booth, MD, Seton Health Systems; J.C. Laughlin, MD, Longmont United Hospital; A. Schmitz, BS, University of Chicago Hospitals. Address reprint requests to Dr. T.O. Utset, University of Chicago, Section of Rheumatology, 5841 S. Maryland Ave., MC 0930, Chicago, IL 60637. E-mail: tutset@medicine.bsd.uchicago.edu Accepted for publication January 16, 2008. |
