ABSTRACT
Objective To study the characteristics of work disability and its influencing factors in patients with ankylosing spondylitis (AS). Methods The demographic data, work conditons and disease related characteristics of 277 patients with AS were recorded, and randomly selected from the Department of Rheumatology, Chinese PLA General Hospital from November 2014 to January 2016. Work and productivity activity impair-ment questionnaire (WPAI) was used to survey the work disability and productivity loss, then explore its in-fluencing factors and the relationships between patient-reported outcomes and WPAI scores. Logistic regression was used to analyze the associated factors of work disability. Multivariate linear regression was used to analyze the predictive factors of lose of work productivity. Results The prevalence of work disability was 30.3%. Twenty patients were unemployed because of working disability. Two hudreds patients were employed, with average 36.5 (24.0, 50.0) hours workingtime in the past week. Average AS related absenteeism was 4.4 (0, 10) hour. Average workproductivity loss was 26.4%(2.5%, 40.0%). Logistic multiple regression analysis showed that Bath AS disease activity index (BASDAI), SF-36 physical component summary (PCS) scores might be the important influencing factors among those clinical measures ( OR=1.270, 0.959). Presenteeism and overall work impairment were moderately correlated with patients' global assessment of disease activity (VAS), BASDAI, bath AS functional index (BASFI), SF-36 physical Functioning (PF), SF-36 body pain (BP) and SF-36 Physical Component Summary (PCS) (|r|=0.539-0.648). Linear multivariate analyses indicated that work presente-eismand absenteeismwere significantly associated with BASDAI (P<0.01). Conclusion High prevalence of work disability in patients with AS is noted, which is closely related with disease activity and body function;High attention should be paid to AS patients with work disability.
ABSTRACT
Objective To evaluate the clinical value of low-dose semicoronal computerized tomography (CT) of sacroiliac joints (SIJ) in the early diagnosis of ankylosing spondylitis (AS).Methods Patients who were diagnosed with AS and had received axial CT examination of SIJs over the past 2 years were recruited.All of them simultaneously underwent a low-dose semicoronal CT of SIJs.The clinical data were recorded.Radiation dose was compared between low-dose CT and the previous conventional axial CT.Image quality of low-dose CT was assessed and correlation between image quality and weight or body mass index (BMI) was analyzed.CT images of the two groups were graded by modified New York criteria, the Lee criteria and the Innsbruck criteria.The kappa coefficient was used to assess the consistency of grading between the two groups.Results Thirty-three patients were enrolled in this study.The effective dose (ED) of semicoronal SIJ CT was 3.37 mSv which was 49％ lower than conventional axial CT (6.56 mSv).Lower dose had the potential protection of gonads.The quality of images in male patients with BMI ＜ 25 kg/m2 and all female patients were good or excellent.There was a significant negative correlation between image quality and BMI (r =-0.746, P =0.000;r =-0.784, P =0.000;respectively).All patients were diagnosed as sacroiliitis by modified New York criteria and the grading of two groups was consistent.The consistency of grading between two groups was satisfactory no matter which classification criteria was used.(k =0.897 with Lee criteria;k =0.814 with Innsbruck criteria;P ＞ 0.05).Conclusions The radiation dose of semicoronal SIJ CT is significantly lower than that of the conventional axial CT with comparable efficacy of diagnosis.