Health, marital and occupational state of patients with Crohn's disease relative to their non- IBD affected siblings and peers

Background:

Health related quality of life (HRQoL), occupational and social life are impaired in patients with Crohn's disease (CD). Studies investigating the impact of CD on these components by direct comparison to non-IBD controls from a similar environment are missing.

Methods:

Hundered patients with CD and 40 non-IBD controls, recruited by the patients from their social environment, i.e. siblings and peers were included. Social, economic and HRQoL data, assessed by SF-12 and EQ-5D were compared between both groups. CD specific predictors for impaired HRQoL, including disease activity, measured by Harvey Bradshaw Index, were delineated from logistic regression.

Results:

Occupational status was different in CD-patients compared to controls (p = 0.004), e.g. resulting in lower employment (65% vs. 83%) and higher early-retirement rates (20% vs. 5%) in patients. Physical health (PCS-12: 45,95 ± 10.1 vs. 51.36 ± 8.0, p = 0.003) and mental health (MCS-12: 48.24 ± 9.8 vs. 52.57 ± 6.9), of the SF-12 scored lower compared to controls. EQ-5D identified impaired general health by EQ 5-D-VAS (71.4 ± 21.5; 81.2 ± 16.3; p = 0.01), as well as limitations through pain/discomfort and in usual activities (p = 0.005). Disease activity was the only independent risk factor associated with both lower physical (OR 4.0; 95% CI: 2.3 – 8.9; p < 0.001) and mental (OR 2.7; 95% CI: 1.6 – 5.0; p < 0.001) scores. Unemployment too showed negative impact on HRQoL. Patients with perianal disease were impaired in PCS-12 (OR 3.4; 95% CI: 1.5 – 8.0; p = 0.003) with limitations in usual life and mobility (EQ-5D).

Conclusions:

Our study points toward significant limitations in CD patients' lives compared to matched controls from a similar environment.