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To determine the prevalence of work disability (WD) in Egyptian patients with ankylosing spondylitis (AS) and to identify the main factors associated with this.A cross-sectional survey was conducted among all patients with AS during an extended outpatient visit in the period between July, 2011 and December, 2012. Demographic data were collected and a physical examination was performed. Multivariate modeling was applied to determine the factors associated with work disability.The questionnaire was completed by 90 patients (85 males; 94.4%). The mean age of the participants was 37.8 (SD 9.7) years, mean disease duration was 12.1 (SD 8.9) years, and the mean symptom duration was 15 (SD 2.9) years. A total of 36 (40%) patients of working age were not working due to AS. The factors that associated with work disability, after completing logistic regression models, were older age (odds ratio [OR] = 1.8, 95%, confidence interval [CI] = 1.04–1.17), longer disease duration (OR = 1.60, 95% CI = 1.12–2.8), increasing diagnostic delay (OR = 2.1, 95% CI = 1.0–3.4), lower educational level (OR = 3.5, 95% CI = 1.6–6.4), manual profession (OR = 1.80, 95% CI = 1.10–2.6), living in a rural zone (OR = 3.14, 95% CI = 1.98–5.05), peripheral arthritis (OR = 2.04, 95% CI = 1.20–3.43) and psychological symptoms (OR = 2.3, 95% CI = 1.9–4.6).The prevalence of WD among Egyptian patients with AS is considerably high. Clinical and psychosocial factors, in particular, appear to be associated with WD and should therefore be prioritized in clinical practice.