Prevalence of disability in inflammatory bowel disease: a systematic review and meta-analysis.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Inflammatory Bowel Diseases Pub Date : 2026-03-05 DOI:10.1093/ibd/izag022

Olga Maria Nardone, Giulio Calabrese, Alexander C Ford, Fabiana Castiglione, Edoardo Vincenzo Savarino, Vipul Jairath, Yuhong Yuan, Silvio Danese, Tommaso Lorenzo Parigi, Brigida Barberio

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Abstract

Background and aims: Disability is a multidimensional concept that includes physical, psychological, and social limitations affecting individuals with inflammatory bowel disease (IBD). Disability is shaped by cultural and health care factors that vary across countries and therefore disability prevalence and characteristics may differ globally. We conducted a systematic review with meta-analysis to assess the pooled prevalence of moderate-to-severe disability and investigate how IBD type, disease activity, geographic location, and questionnaire used influenced prevalence.

Methods: We searched MEDLINE, Embase, and Embase Classic (from database inception to March 1, 2025) for cross-sectional, cohort, registry-based, and case-control studies reporting the prevalence of moderate-to-severe disability based on the IBD Disk or IBD-Disability Index in adults with confirmed IBD.

Results: In total, 17 articles fulfilled the eligibility criteria, including 7897 patients in 17 countries. The pooled prevalence of moderate-to-severe disability in patients with IBD was 29.6% (95% CI, 22.6%-37.1%) and was higher in patients with active IBD (56.9%; 95% CI, 20.3%-89.9%) compared with those with inactive disease (27.0%, 95% CI, 3.3%-62.0%). Based on 3 studies, disease activity increased the odds of moderate-to-severe disability more than 3-fold (odds ratio [OR], 3.13, 95% CI, 1.74-5.64). Stratified by IBD type, moderate-to-severe disability was higher in patients with Crohn disease (36.9%; 95% CI, 25.7%-48.9%) than in ulcerative colitis (30.8%; 95% CI, 19.6%-43.2%), with OR 1.26 (95% CI, 1.06-1.51).

Conclusions: This systematic review is the first, to our knowledge, to show that moderate-to-severe disability affects nearly one-third of patients with IBD, with higher rates in Crohn disease and active disease. Importantly, disability persists in a substantial proportion of patients even during remission, supporting the need for systematic assessment across clinical settings.

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炎症性肠病致残率：一项系统综述和荟萃分析

背景和目的：残疾是一个多维度的概念，包括影响炎症性肠病（IBD）患者的身体、心理和社会限制。残疾受到文化和保健因素的影响，这些因素因国家而异，因此残疾的流行程度和特征在全球可能有所不同。我们通过荟萃分析进行了一项系统综述，以评估中度至重度残疾的总患病率，并调查IBD类型、疾病活动性、地理位置和问卷使用对患病率的影响。方法：我们检索MEDLINE、Embase和Embase Classic（从数据库建立到2025年3月1日）的横断面、队列、基于登记的和病例对照的研究，这些研究报告了基于IBD Disk或IBD- disability Index的确诊IBD成人中中度至重度残疾的患病率。结果：共有17篇文章符合入选标准，包括来自17个国家的7897例患者。IBD患者中中度至重度残疾的总患病率为29.6% (95% CI, 22.6%-37.1%)，活动性IBD患者（56.9%,95% CI, 20.3%-89.9%）高于非活动性IBD患者（27.0%,95% CI, 3.3%-62.0%）。根据3项研究，疾病活动使中度至重度残疾的几率增加了3倍以上（优势比[OR]， 3.13, 95% CI, 1.74-5.64）。按IBD类型分层，克罗恩病患者的中度至重度致残率（36.9%,95% CI, 25.7%-48.9%）高于溃疡性结肠炎患者（30.8%,95% CI, 19.6%-43.2%）， OR为1.26 （95% CI, 1.06-1.51）。结论：据我们所知，该系统综述首次表明，中度至重度残疾影响了近三分之一的IBD患者，其中克罗恩病和活动性疾病的比例更高。重要的是，即使在缓解期，仍有相当比例的患者存在残疾，这支持了在临床环境中进行系统评估的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.