Determinants of work disability in patients with systemic sclerosis: a longitudinal study of the GENISOS cohort.
Title | Determinants of work disability in patients with systemic sclerosis: a longitudinal study of the GENISOS cohort. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Sharif R, Mayes MD, Nicassio PM, Gonzalez EB, Draeger H, McNearney TA, Estrada-Y-Martin RM, Nair DK, Reveille JD, Arnett FC, Assassi S |
Corporate Authors | GENISOS Study Group |
Journal | Semin Arthritis Rheum |
Volume | 41 |
Issue | 1 |
Pagination | 38-47 |
Date Published | 2011 Aug |
ISSN | 1532-866X |
Keywords | Disabled Persons, Employment, Female, Humans, Longitudinal Studies, Male, Middle Aged, Psychology, Scleroderma, Systemic, Severity of Illness Index, Texas, Work Capacity Evaluation |
Abstract | OBJECTIVES: To determine the prevalence, correlates, and predictors of work disability (WD) in the Genetics versus ENvironment In Scleroderma Outcome Study (GENISOS). We hypothesized that WD in systemic sclerosis (SSc) is a function of demographic, clinical, and psychosocial factors. METHODS: Patients enrolled in the GENISOS cohort were subdivided in 3 groups: work disabled, working, and retired or homemakers. The latter group (n = 29) was excluded from further analysis. We used logistic regression analysis with a forward hierarchical variable selection strategy to investigate the independent correlates of WD at enrollment. Cox regression proportional Hazard's model with a similar variable selection strategy was utilized to determine the predictors of WD in those working at enrollment. RESULTS: Overall, 284 patients with a mean age of 48.7 years and disease duration of 2.5 (±1.6) years were enrolled into the GENISOS cohort, consisting of 83.5% female, 46.8% white, 28.9% Hispanic, and 20.4% African American. Patients were longitudinally followed in 1438 study visits. At enrollment, 124 patients (43.7%) were work disabled, whereas 131 (46.1%) were working. Lower level of education (P < 0.001), higher Medsger Lung Severity Index (P = 0.012), higher Fatigue Severity Score (P = 0.008), and less social support (P < 0.001) correlated independently with WD. Of those working at baseline, 35 (26.7%) eventually developed WD. Non-white ethnicity (P = 0.038), lower DLCO % predicted value (P = 0.038), and higher Fatigue Severity Score (P = 0.009) at enrollment independently predicted WD on follow-up visits. CONCLUSIONS: WD is a major problem among SSc patients and its prevalence is substantially higher than other rheumatic conditions. Demographic, clinical, and psychosocial factors correlate with WD cross-sectionally and predict WD longitudinally in these patients. |
DOI | 10.1016/j.semarthrit.2011.01.002 |
Alternate Journal | Semin. Arthritis Rheum. |
PubMed ID | 21429562 |
PubMed Central ID | PMC3153604 |
Grant List | 5T32-AR052283-03 / AR / NIAMS NIH HHS / United States KL2 RR024149 / RR / NCRR NIH HHS / United States KL2 RR024149-04 / RR / NCRR NIH HHS / United States KL2 RR024149-05 / RR / NCRR NIH HHS / United States KL2RR024149-04 / RR / NCRR NIH HHS / United States M01 RR000073 / RR / NCRR NIH HHS / United States M01 RR000073-37 / RR / NCRR NIH HHS / United States M01 RR000073-38 / RR / NCRR NIH HHS / United States M01 RR000073-39 / RR / NCRR NIH HHS / United States M01 RR000073-40 / RR / NCRR NIH HHS / United States M01 RR000073-41 / RR / NCRR NIH HHS / United States M01 RR001346 / RR / NCRR NIH HHS / United States M01 RR001346-25 / RR / NCRR NIH HHS / United States M01 RR001346-26 / RR / NCRR NIH HHS / United States M01 RR001346-27 / RR / NCRR NIH HHS / United States M01-RR00073 / RR / NCRR NIH HHS / United States M01-RR01346 / RR / NCRR NIH HHS / United States N01 AR002251 / AR / NIAMS NIH HHS / United States N01 AR002251-013 / AR / NIAMS NIH HHS / United States P50 AR054144 / AR / NIAMS NIH HHS / United States P50 AR054144-01 / AR / NIAMS NIH HHS / United States P50 AR054144-02 / AR / NIAMS NIH HHS / United States P50 AR054144-03 / AR / NIAMS NIH HHS / United States P50 AR054144-04 / AR / NIAMS NIH HHS / United States P50 AR054144-05 / AR / NIAMS NIH HHS / United States P50AR054144 / AR / NIAMS NIH HHS / United States T32 AR052283 / AR / NIAMS NIH HHS / United States T32 AR052283-03 / AR / NIAMS NIH HHS / United States T32 AR052283-04 / AR / NIAMS NIH HHS / United States TL1 RR024147 / RR / NCRR NIH HHS / United States TL1 RR024147 / RR / NCRR NIH HHS / United States TL1 RR024147-03 / RR / NCRR NIH HHS / United States TL1 RR024147-04 / RR / NCRR NIH HHS / United States TL1 RR024147-05 / RR / NCRR NIH HHS / United States UL1 RR024148 / RR / NCRR NIH HHS / United States UL1 RR024148-03 / RR / NCRR NIH HHS / United States UL1 RR024148-04 / RR / NCRR NIH HHS / United States UL1 RR024148-05 / RR / NCRR NIH HHS / United States UL1-RR024148 / RR / NCRR NIH HHS / United States |