Patients with ulcerative colitis miss more days of work than the general population, even following colectomy

Abstract

Background & aims: It is unclear whether colectomy restores the ability of patients with ulcerative colitis (UC) to work to precolectomy levels. We estimated the burden of sick leave and disability pension in a population-based cohort of patients with UC and the effects of colectomy.

Methods: We performed a register-based cohort study using the Swedish National Patient Register and identified working-age patients with UC in 2005 (n = 19,714) and patients who underwent colectomies between 1998 and 2002 (n = 807). Sick leave and disability pension data were retrieved from Statistics Sweden (1995-2005). Data from each patient in the study were compared with those from 5 age-, sex-, education-, and county-matched individuals from the general population.

Results: In 2005, 15% of patients with prevalent UC received a disability pension, compared with 11% of the general population, and 21% vs 13% had ≥1 sick leave episode (P < .001 for each comparison). The annual median work days lost was 0 in both groups, but patients with UC had higher mean (65 vs 45 days; difference, 20; 95% confidence interval [CI], 18-22 days) and 75th percentile work days lost (37 vs 0 days; difference, 37; 95% CI, 36-38 days). Among patients who underwent colectomies, annual days lost increased from a mean of 40 (median, 0) days 3 years before surgery to 141 (median, 99) days during the year of surgery (P < .001). The number then decreased to a mean of 85 days 3 years after surgery (median, 0). The corresponding 75th percentile days were 17, 207, and 130, respectively. Three years after colectomy, 12% did not work at all compared with 7.2% of the general population (risk difference, 5.2%; 95% CI, 2.7%-7.7%) and compared with 5.9% 3 years before colectomy (P < .001).

Conclusions: Patients with UC miss more work days than the general population in Sweden. Although most patients had no registered work loss 3 years after colectomy, work loss was not restored to presurgery or general population levels in the group that underwent colectomy during several years of follow-up.