Multivariate logistic regression analysis of disability assessment and influencing factors in patients with inflammatory bowel disease using the disability index of inflammatory bowel disease: implications for prevention and treatment of inflammatory bowel disease

Multivariate logistic regression analysis of disability assessment and influencing factors in patients with inflammatory bowel disease using the disability index of inflammatory bowel disease: implications for prevention and treatment of inflammatory bowel disease | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Multivariate logistic regression analysis of disability assessment and influencing factors in patients with inflammatory bowel disease using the disability index of inflammatory bowel disease: implications for prevention and treatment of inflammatory bowel disease Le Xu, Xing Hu, Qingquan Bi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6921885/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective The clinical value of using inflammatory bowel disease disability index (IBD-DI) was explored to evaluate disability in patients with inflammatory bowel disease (IBD). IBD patients' disability risk factors were analyzed using multivariate logistic regression analysis in order to provide clinical guidance on prevention and treatment of IBD. Methods From February 2019 to June 2022, 290 patients with IBD cured in our hospital. There were 87 patients without disabilities as the control group and 203 patients with disabilities as the study group. The general data were compared to analyze the clinical value of IBD-DI in evaluating the disability of IBD patients. To analyze the risk factors for disability in patients with IBD, multivariate logistic regression was used. Results Among the 290 patients, 203 patients had different degrees of disability according to the national standard "Classification and Grading of Disabled Persons". There were statistically noticeable differences in age, sex, education level, average annual family income, whether to work, frequency of physical exercise and duration of physical exercise. There were noticeable differences in diagnosis age, surgical history, glucocorticoid use and biological agents use ( P < 0.05). The IBD-DI score of the study group was noticeably higher ( P < 0.05). The area under the curve (AUC) of IBD-DI score to evaluate the disability degree of IBD patients was 0.842, and 95% confidence interval (95%CI) was 0.758–0.925. Logistic regression analysis indicated that age, average annual family income, work, length of physical exercise each time, age of diagnosed disease, surgical history and IBD-DI score were the risk factors of disability in patients with IBD. Conclusion A validated and reliable tool for assessing disability in Chinese patients with IBD is the IBD-DI. Patient age, average annual household income, duration of work and physical activity, age at diagnosis of disease, surgical history and IBD-DI score are risk factors for disability in patients with IBD. It is anticipated that in the future it will be possible to evaluate the degree of disability of patients based on the IBD-DI to guide clinical decision making and enable stratified management of patients. IBD-DI IBD Disability IBD-DI score Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Inflammatory bowel disease (IBD) is a global disease, including Crohn's disease (CD), Ulcerative colitis (UC), and undetermined IBD (IBD-U), which has certain influence on intestinal mucosa, is a series of nonspecific gastrointestinal diseases characterized by chronic recurrent inflammation [ 1 ]. During the past few decades, IBD incidence has steadily increased worldwide [ 2 ]. China has experienced an increase in the incidence of inflammatory bowel disease (IBD) over the last 20 years, with IBD patients exceeding 1.5 million in 2025 [ 3 ]. IBD is characterized by a variety of physical and psychological symptoms, with clinical signs such as abdominal pain, diarrhea, bloody stools, anorexia, weight loss, depression and anxiety [ 4 ]. IBD is common in young adults, and the onset age is gradually younger. Recurrent episodes of IBD can have a negative physical, psychological, family, economic and social impact on patients, reducing their personal life quality, work and relationships [ 5 ]. IBD can noticeably affect the life quality of patients, and early diagnosis and treatment are key to controlling the progression of the disease. Therefore, the risk factors for disability in IBD are very essential and will help to improve the management of those at risk, thus reducing morbidity and improving the life quality of patients [ 6 ]. Disability is the experience of physical function and structure damage, limited activity and limited participation in the interaction with environmental factors, which refers to the objective issues that patients may exist in different fields [ 7 ]. Most patients develop the disease at a young age, with repeated episodes of cumulative bowel damage, various extra-intestinal manifestations and adverse consequences of treatment, all of which can lead to disability [ 8 ]. Compared with patients with ulcerative colitis, patients with Crohn's disease are more restricted in their daily life, especially in the fields of interpersonal relationships, activities and participation [ 9 ]. The goals of treatment for IBD range from symptom control to complete control of the disease in the pursuit of improving the patient's life quality, improving prognosis and reducing the risk of disability [ 10 ]. In 2011, the inflammatory Bowel Disease Disability Index (IBD-DI) was developed based on the World Health Organization (WHO) International Classification of function, international classification of functioning of disability and health (ICF) [ 11 ], the first tool specifically used to assess related disabilities in patients with IBD. Currently, most attention to patient self-reported outcomes focuses on the patient's life quality. Life quality is the subjective experience of the limitations imposed by the disease, rather than the limitations being assessed. In other words, disability refers to the objective limitations that patients may have in different areas, whereas life quality refers to how these limitations are perceived subjectively by the patient. The life quality is subjective and related to a person's coping strategies and cognitive level, while disability reflects the objective loss of personal function and the cost of disease to society. At present, there are few reports on using IBD-DI to evaluate and analyze the influencing factors of disability in patients with IBO, and the application value of IBD-DI and the risk factors of disability in IBD patients are not clear. It is necessary to carry out further research. This study specifically discussed the clinical value of IBD-DI in evaluating disability in IBD patients, and used multi-factor logistic regression to analyze the risk factors of disability in IBD patients, so as to offer reference to prevent and treat IBD clinically. Patients and methods 1.1 General information During February 2019 to June 2022, 290 patients with IBD cured in our hospital were evaluated according to the national standard "International Classification of functional Disability and Health" [ 12 ]. There were 87 patients without disabilities as the control group and 203 patients with disabilities as the study group. The general data of all patients are shown in Table 1 . All participants signed the informed consent form for this study, which was approved by our hospital's Medical Ethics Council. Inclusion criteria: 1) all cases met the diagnostic criteria of IBD [ 13 ], and the diagnosis time was more than 3 months; 2) the patient had reached the age of 18 years; 3) there were no other serious diseases and no serious mental disorders; 4) subjects had normal communication and comprehension skills and were able to complete the questionnaire alone or with the help of others; 5) upon signing the informed consent form, patients agreed to take part in the study. Exclusion criteria: 1) those who were unwilling to participate in this study; 2) those who could not understand the contents of the questionnaire; 3) those were under the age of 18 years; 4) those with other serious diseases such as chronic obstructive pulmonary disease, severe lung infections, cardiac insufficiency, severe liver and kidney insufficiency, diabetes mellitus, hyperthyroidism, severe mental disorders, etc. The Clinical Technology Application Ethics Committee of the First Affiliated Hospital of Anhui Medical University approved this study protocol, which was in accordance with the Declaration of Helsinki. Patients gave written informed consent. Treatment methods According to the "General data questionnaire" filled in by the patients, the general data of all selected patients were harvested, containing the frequency of physical exercise, the length of physical exercise, age, sex, educational level, average annual family income, marital status, whether to work, body mass index (BMI), residence, smoking history, drinking history. The disease characteristics of the two groups were recorded and compared, such as the course of disease, the age of diagnosed disease, the history of operation, the history of total enteral nutrition, the history of medication and so on. 1.2 Observation index The ICF provides a comprehensive WHO standard that can classify and describe the function, disability and health of any patient. Based on ICF, the disability index-IBD-DI was developed to evaluate the degree of disability in IBD patients. The complete development process of the scale was published in GLT magazine in 2011. According to the relevant literature [ 14 ], the items of the 5-point Likert scale of IBD-DI were counted as 0Mur4, the binary items as "No" = 0, "Yes" = 4, BMI > 18.5 as 0, and BMI ≤ 18.5 as 4. The score of diarrheas is as follows: "0 times" = 0, "1–7 times" = 1, "8–18 times" = 2 points, "19–29 times" = 3 points,"≥ 30 times" = 4 points; The score of hematochezia is as follows: "None" =0, "Light" =2, "Heavy" =4. Then, sum the scores of all the items, and re-score the total score of IBD-DI with the total score ×100/(p×4), with range from 0-100 scores, where p value is the number of items answered. The higher the score of IBD-DI, the higher the degree of disability. IBD-DI score was performed on the day of admission or the next day (Table 1 ). Table 1 Chinese version of IBD-DI scoring method Topic type Title number Scoring method 5-point Likert scale item 1–12 1–4 points Fecal frequency 12 0 times = 0 points, 1–7 times = 1 points, 8–18 times = 2 points, 19–29 times = 3 points, ≥ 30 times = 4 points BMI 14 >18.5kg/m2 = 0 points, ≤ 18.5kg/m2 = 4 points Binary item 15、17 No = 0 points, Yes = 4 points Blood in stool 16 None = 0 points, Light = 2 points, Heavy = 4 points 1.3 Statistical analysis The data were analyzed and processed by SPSS21.0 statistical software. In order to perform statistical analysis, the measurement data were first analyzed for normal distribution and variance homogeneity. A (± s) symbol is used to indicate measurements with a normal distribution or approximate normal distribution. The group was compared using a paired t-test, while the two groups were compared using an independent sample t-test. The n (%) was adopted to represent the counting data, and χ 2 test was adopted. IBD-ID rating values were analyzed by receiver operating characteristic curve (ROC), and risk factors for disability in IBD patients were analyzed by Logistic ITC multivariate regression, with P < 0.05 indicating a statistically noticeable difference. Results 2.1 Division of disability degree Among the 290 patients, all completed the evaluation of IBD-DI and national standard "Classification and grading of Disability". According to the classification and classification of disabled persons according to the national standard, 203 patients had varying degrees of disability, and 200 patients had varying degrees of disability according to IBD-DI criteria. All the data results are shown in Fig. 1 – 2 . 2.2 Comparison of general data No noticeable difference was found in marital status, BMI index, residence, smoking and drinking history (P > 0.05). There were noticeable differences in age, sex, education level, average annual family income, work or not, frequency and duration of physical exercise (P < 0.05). You can see all the data results in Table 2 . Table 2 The general data Project Control group (n = 87) Research group(n = 203) χ2/t P Age 34.93 ± 2.94 41.93 ± 2.95 158.693 <0.01 Gender (male / female) 36/51 154/49 32.052 <0.01 degree of education 23.856 <0.01 Illiterate 1(1.15) 6(2.96) Primary school 7(8.05) 16(7.88) Junior middle school 11(12.64) 74(36.45) high school 26(29.89) 59(29.06) College or above 42(48.29) 48(23.65) Average annual household income 60.166 15 thousand 62(71.26) 48(23.65) Marital status 0.767 >0.05 Unmarried 8(9.2) 26(12.81) Married 79(90.80) 177(87.19) Work (yes / no) 71/16 107/96 20.156 <0.01 Frequency of physical exercise (every week / time) 76.120 3 49(56.32) 19(9.36) The length of each physical exercise(hours) 31.739 2h 31(35.63) 19(9.36) BMI(kg/m 2 ) 23.44 ± 2.35 23.50 ± 2.40 0.196 >0.05 home place 0.160 >0.05 Rural areas 33(37.93) 72(35.47) City 54(62.07) 131(64.53) Smoking history 38(43.68) 92(45.32) 0.066 >0.05 History of drinking 40(45.98) 110(54.19) 1.644 >0.05 2.3 Comparison of disease characteristics No noticeable difference was found in the characteristics of parenteral diseases, enteral nutrition history, use of immunosuppressants, use of 5-aminosalicylicacidome 5-Methyl ASA, use of traditional Chinese medicine and no use of drugs (P > 0.05). There were noticeable differences in age of diagnosis, history of operation, use of corticosteroids and biological agents (P < 0.05). You can see all the data results in Table 3 . Table 3 The disease characteristics Project Control group (n = 87) Research group(n = 203) χ2/t P Course of disease 3.45 ± 0.13 6.28 ± 0.83 31.606 <0.01 Age of diagnosed disease 45.18 ± 2.86 38.59 ± 4.24 13.255 <0.01 Surgical history 94.427 0.05 History of total enteral nutrition 45(51.72) 129(63.55) 3.546 >0.05 Glucocorticoid 40(45.98) 147(72.41) 18.584 0.05 5-ASA 58(66.67) 152(74.88) 2.055 >0.05 Biological agents 51(58.62) 148(72.91) 5.772 0.05 Unused medicine 8(9.20) 27(13.30) 0.976 >0.05 2.4 Comparison of IBD-DI score The IBD-DI score of the study group was noticeably higher (P < 0.05). You can see all the data results in Fig. 3 . 2.5 ROC curve of IBD-DI score for evaluating disability degree of IBD patients The Area Under Curve (AUC) of IBD-DI score in evaluating the degree of disability of patients with IBD was 0.842, and the 95% confidence interval (95% CI) was 0.758 to 0.925. The value of IBD-DI score in evaluating the degree of disability of patients with IBD was high (Fig. 4 ). 2.6 Risk factors of disability in patients with IBD Age, gender, education, mean annual household income, job, frequency of physical activity, duration of physical activity, duration of illness, age at diagnosis, history of surgery, glucocorticoid use, biologic use and IBD-DI score were the independent variables, with disability as the dependent variable (yes = 1, no = 0). The allocation table is shown in Table 4 . Logistic regression analysis showed that age, average annual family income, work, duration of physical exercise, age of diagnosed disease, history of operation and IBD-DI score were the risk factors for disability in patients with IBD. You can see all the data results in Table 5 . Table 4 Assignment table of independent variables Independent variable Assignment Independent variable Assignment Age Continuous variable Course of disease Continuous variable Gender Male = 1, Female = 0 Age of diagnosed disease Continuous variable degree of education Senior high school and below = 1, College or above = 0 Surgical history Yes = 1, None = 0 Average annual household income ≤ 150,000 per year = 1,, >150,000/year = 0 Used glucocorticoid Yes = 1, None = 0 Work None = 1, Yes = 0 Used biological agents Yes = 1, None = 0 Frequency of physical exercise ≤ 3 times/week = 1, >3 times/week = 0 IBD-DI Scoring Continuous variable The length of each physical exercise ≤ 2h = 1, >2h = 0 Table 5 Analysis of risk factors of disability in patients with IBD Variable b S.E Chi-square value P OR 95% CI for OR Age 2.424 0.855 8.038 0.005 11.291 2.113–60.328 Gender (male / female) 1.842 0.834 4.878 0.027 6.309 1.230-32.351 Degree of education 1.953 1.052 3.446 0.063 7.050 0.897–55.419 Average annual household income 1.844 0.316 34.052 0.000 6.322 3.403–11.744 Work 0.943 0.244 14.936 0.000 2.568 1.592–4.142 Frequency of physical exercise 1.391 0.723 3.701 0.054 4.019 0.974–16.578 The length of each physical exercise 0.844 0.245 11.867 0.001 2.326 1.439–3.759 Course of disease 0.984 1.330 0.547 0.459 2.675 0.197–36.263 Age of diagnosed disease 0.982 0.331 8.802 0.003 2.670 1.395–5.108 Surgical history 1.053 0.324 10.563 0.001 2.866 1.519–5.409 Glucocorticoid 0.943 0.842 1.254 0.263 2.568 0.493–13.347 Biological agents 1.313 0.832 2.490 0.115 3.717 0.728–18.986 IBD-DI Scoring 1.845 0.312 34.969 0.000 6.328 3.433–11.664 Discussion Increasing every year in recent years, IBD is a global condition that is more prevalent in western countries [ 15 ]. In the past few decades, the prevalence rate in countries or regions such as South Korea, Japan, India and China is getting higher and higher, and the incidence population has shown a younger trend [ 16 ]. There are differences in geographical distribution, age and sex among the subtypes of IBD. Of 447 French patients with IBD who participated in the IBD-Disk cohort study, 70.9% had Crohn's disease [ 17 ]. The clinical data of some scholars on the Chinese version of IBD-DI show that Crohn's disease accounts for the majority of patients with IBD [ 18 ]. In total, 63 patients had ulcerative colitis while 107 had Crohn's disease. Up to 73.2% of this study's patients had ulcerative colitis, which is consistent with the epidemiology and regional distribution of IBD in China. The prevalence rate of ulcerative colitis in northern China is higher than that in southern China. Three one-year prospective IBD epidemiological studies based on urban population show that the incidence of ulcerative colitis is higher compared to Crohn's disease in some areas of northern China [ 19 ]. IBD damages the social and functional ability of patients by affecting their physical and emotional health, and then has an important impact on their health status and life quality [ 20 ]. Disability is defined as an abnormality or loss of anatomical and physiological functions of the human body, such as various physical, psychological and mental disorders or losses and congenital abnormalities. Disability can result in long-term, persistent or permanent physical impairment and affect physical activity, daily living and social communication [ 21 ]. With the change of treatment mode, patients' requirements for life quality are gradually increasing, and the prevention of intestinal injury and disability has become a new treatment goal. Crohn and ulcerative colitis have high disability rates and will increase the burden of disease. In the last decade, more objective tools have been found to measure disability in order to better assess it [ 22 – 24 ] and to prevent its onset early. IBD-DI is the first specific index to be adopted as a tool to measure disability in IBD, and its complete development process was published in GUT in 2011 [ 25 ]. The formulation and development of IBD-ID is a long-term and gradual process. First, a large expert survey was conducted with 125 experts from 37 countries, including all health professionals working with people with IBD, such as doctors, nurses, psychologists and dieticians [ 26 ]. A cross-sectional study involving three different centers was also conducted, one in the United States and two in Europe [ 27 ]. On the basis of systematic literature review, qualitative research, expert investigation and cross-sectional research, different measurement standards are selected from "ICF". In 2010, 20 experts from 17 countries participated in a consensus meeting held in Switzerland to develop the final outcome of the IBD-ID [ 28 ]. The IBD-ID contains a total of 28 questions. The first question asks about the patient's general health, 17 questions include the severity of the patient's limitations in terms of sleep and energy, mood, body image, abdominal pain, bowel movements, participation in social activities, work and education, 8 questions relate to environmental factors, to positive or negative effects of medication, food, family and medical personnel, and the last two questions relate to social security and the health care system [ 29 – 30 ]. Currently, the IBD-ID has been adapted from its original English version to French, Portuguese, Australian, Dutch, Belgian, Canadian, Spanish, Singaporean and Chinese versions, and the index has proven to be a reliable and effective tool through clinical data. It can help clinicians guide different treatment decisions [ 31 ]. Foreign scholars translated IBD-DI into Portuguese, and two researchers investigated IBD patients at baseline, 4 weeks and 4 months later. Analyzing the factors, we determined that the scale is singular and reduced it to 14 items as a result [ 32 ]. In Portuguese IBD patients, the Portuguese version of IBD-DI is reliable, effective, responsive, and understandable [ 33 ]. In collaboration with the original developers of the IBD-DI, Gower-Rousseau et al. translated the original IBD-DI into French and then surveyed a random sample of 200 adult IBD patients diagnosed with IBD in the French population register [ 34 ]. The resulting French version of IBD-DI includes 14 questions with scores ranging from 0 to 100, with an average score of 35.3, the intra-group correlation coefficient was 0.91 and the internal consistency Cronbach's a was 0.86. A prospective study of 322 patients with IBD using the Korean version of the IBD-DI by foreign scholars found that IBD-DI scores for UC (r = 0.636, p < 0.001) and CD (r = 0.711, p < 0.001) correlated with CUCQ-8 scores [ 35 ]. Foreign scholars translated the Danish version of the IBD-DI with a Cronbach'a of 0.91 for all 14 items of the questionnaire and a strong correlation between the IBD-DI and SIBDO (Person correlation coefficient = -0.81) [ 36 ]. The internal consistency score of IBD-DI is "good", the reliability within observers is "good", the reliability among observers is "excellent", and the structural validity is "moderately strong" to "very strong". The structural validity is mainly single-dimensional and has good responsiveness, but its interpretability is only useful in groups. Up to now, there is little research on IBD-DI in China. A New Zealand study has suggested that the self-report of the disability index of IBD is a simple self-report tool for measuring the disability of IBD, which can be applied to patients' own clinical practice [ 37 ]. As science and technology and the improvement of people's lives have developed, the requirements for questionnaires have gradually increased. Not only does the IBD-DI dynamically assess a patient's impact on different aspects of their lives, it may also serve as a clinical decision-making tool for gastroenterologists [ 38 ]. Combined with the results of this study, all 290 patients have completed the evaluation of IBD-DI and the national standard International Classification of Functional Disability and Health. Among 290 patients, 203 patients have different degrees of disability; According to the IBD-DI standard, 200 patients have different degrees of disability. It can be seen that there is little difference between IBD-DI and the International Classification of Functional Disability and Health. The AUC of IBD-ID score in evaluating the degree of disability of patients with IBD is 0.842( 95%CI = 0.758–0.925). The value of IBD-ID score in evaluating the degree of disability of patients with IBD is high. In our research, 70.0% of IBD patients have different degrees of disability. It can be seen that the incidence of disability in China's IBD population is very high. There are differences in age, sex, education level, average annual family income, whether to work, frequency of physical exercise and duration of physical exercise. There were noticeable differences in the age of diagnosis, surgical history, glucocorticoid use and biological preparation use. The IBD-ID score of the study group was noticeably higher. We found that age, average annual family income, work, length of physical exercise, age of diagnosed disease, surgical history and IBD-DI score were the risk factors of disability in patients with IBD. The elderly are more likely to become disabled due to their poor physical function. Non-working people are also more likely to become disabled due to their lack of exercise and inferior physical function to working people. In addition, low-income households are less concerned about their health, have less investment in health protection and are at higher risk of disability than higher income households. Additionally, people who are less physically active are naturally less fit than those who are more physically active and are therefore more likely to become disabled. The IBD-DI score is an important indicator of the degree of disability, so it is necessary to strengthen clinical observation and intervention for patients with high IBD-DI scores. Therefore, we should strengthen the attention and intervention of the above-mentioned high-risk groups, and take effective treatment measures to improve the length of each physical exercise, so as to reduce the long-term disability of patients. For those IBD patients with older age, lower average annual family income, shorter duration of physical exercise and history of gastrointestinal surgery, we should pay more attention to their disability risk. For those patients with IBD who are receiving total enteral nutrition, physical activity should be encouraged to reduce the degree of disability [ 39 – 40 ]. In clinic, more attention should be paid to the disability risk of IBD patients with a longer course of disease [ 41 ]. Similarly, patients with IBD should be encouraged to take an active part in physical exercise. In short, these patients with high risk factors of disability should be closely monitored and followed up, and effective measures should be taken to intervene, which may be the best way to prevent disability and help patients return to normal life [ 42 – 43 ]. The disability evaluation of IBD patients has been gradually accepted and valued by medical circles all over the world, which can be used in clinical and scientific research to guide clinical decision-making. At present, there is little research in this field in China. IBD-DI is used to evaluate the degree of disability of IBD patients in China and explore the related factors that can affect the degree of disability, which will promote the development of clinical medicine and optimize the allocation of medical resources in China [ 44 – 45 ]. Whether the scale can be widely used in clinical practice and whether there is long-term variability needs to be confirmed in a larger sample. It is anticipated that in the future it will be possible to evaluate the degree of disability of patients based on the IBD-DI, thus guiding clinical decision-making and enabling graded management of patients. Conclusion This study confirmed that IBD-DI is a credible and effective tool for evaluating the degree of disability in Chinese patients with IBD, and can be adopted for clinical quantitative stratified management of patients with IBD. Age, average annual family income, work, length of physical exercise, age of diagnosed disease and history of operation were risk factors for disability in patients with IBD. Declarations Ethics approval and consent to participate We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. Consent for publication Written informed consent was obtained from all participants. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests None of the authors has any conflicts of interest to disclose. Funding Not applicable. Authors' information Not applicable. Authors' contributions Le Xu and Xing Hu wrote the main manuscript text, Qingquan Bi offered references and reviewed the manuscript. Acknowledgements Thanks to Director Yanghua Tian , Director Ling Wei , and Director Juanjuan Zhang for providing the data and materials. Ethics approval and consent to participat e Ethical approval was obtained from Clinical Technology Application Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Declaration of Helsinki).All participants signed the informed consent form for this study. References Seyedian SS, Nokhostin F, Malamir MD. 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Oxidative Stress and Redox-Modulating Therapeutics in Inflammatory Bowel Disease. Trends Mol Med. 2020;26(11):1034-1046. Stallmach A, Reuken PA, Grunert P, Teich N. Chronisch-entzündliche Darmerkrankungen in der COVID-Pandemie: Manifestationen und Management [Inflammatory bowel disease during the COVID-19 pandemic: manifestations and management]. Z Gastroenterol. 2022;60(12):1795-1801. Aniwan S, Santiago P, Loftus EV Jr, Park SH. The epidemiology of inflammatory bowel disease in Asia and Asian immigrants to Western countries. United Eur Gastroenterol . 2022;10(10):1063-1076. Kamperidis N, Kamperidis V, Zegkos T, Kostourou I, Nikolaidou O, Arebi N, Karvounis H. Atherosclerosis and Inflammatory Bowel Disease-Shared Pathogenesis and Implications for Treatment. Angiology. 2021;72(4):303-314. Al Bakir I, Kabir M, Yalchin M, Hart A. Optimising inflammatory bowel disease surveillance and dysplasia management-Where do we stand? United Eur Gastroenterol . 2022;10(10):1054-1062. Czubkowski P, Osiecki M, Szymańska E, Kierkuś J. The risk of cardiovascular complications in inflammatory bowel disease. Clin Exp Med. 2020;20(4):481-491. Gubatan J, Levitte S, Patel A, Balabanis T, Wei MT, Sinha SR. Artificial intelligence applications in inflammatory bowel disease: Emerging technologies and future directions. World J Gastroentero. 2021;27(17):1920-1935. Ahmed S, Vachaparambil C, Kugathasan S. Pediatric inflammatory bowel disease: continuous lessons for adult inflammatory bowel disease. Curr Opin Gastroen. 2019;35(4):265-274. Ludvigsson JF, Andersson M, Bengtsson J, Eberhardson M, Fagerberg UL, Grip O, Halfvarson J, Hjortswang H, Jäghult S, Karling P, Nordenvall C, Olén O, Olsson M, Rejler M, Strid H, Myrelid P. Swedish Inflammatory Bowel Disease Register (SWIBREG) - a nationwide quality register. Scand J Gastroentero. 2019;54(9):1089-1101. Du Y, Rong L, Cong Y, Shen L, Zhang N, Wang B. Macrophage polarization: an effective approach to targeted therapy of inflammatory bowel disease. Expert Opin Ther Tar. 2021;25(3):191-209. Gower-Rousseau C,Sarter H,Savoye G,Tavernier N,Fumery M,Sandborn WJ,et al.Validation of the Inflammatory Bowel Disease Disability Index in a population-based cohort.Gut 2017;66:588-596. Choi S, Moon W. [Pediatric-onset Inflammatory Bowel Disease: What Are Different from Adult in the Treatment?]. Korean J Gastroenterol. 2021;77(5):220-226. Householder S, Picoraro JA. Diagnosis and Classification of Fistula from Inflammatory Bowel Disease and Inflammatory Bowel Disease-Related Surgery. Gastrointest Endosc Clin N Am. 2022;32(4):631-650. Sbeit W, Kadah A, Mahamid M, Karayanni H, Mari A, Tali S, Srouji S, Khoury T. Oral manifestations of inflammatory bowel disease: the neglected piece of the puzzle. Eur J Gastroen Hepat. 2020;32(11):1422-1431. Kudo T, Arai K, Uchida K, Tajiri H, Hokari R, Suzuki Y, Shimizu T. Very early-onset inflammatory bowel disease in Japan: A nationwide survey. J Gastroen Hepatol. 2021;36(1):151-155. Masi L, Capobianco I, Magrì C, Marafini I, Petito V, Scaldaferri F. MicroRNAs as Innovative Biomarkers for Inflammatory Bowel Disease and Prediction of Colorectal Cancer. Int J Mol Sci. 2022;23(14):7991. Dalzell AM, Ba'Ath ME. Paediatric inflammatory bowel disease: review with a focus on practice in low- to middle-income countries. Paediatr Int Child H. 2019;39(1):48-58. Park J, Park S, Lee SA, Park SJ, Cheon JH. Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management. Korean J Intern Med. 2021;36(5):1040-1048. Sinh P, Cross R. Cardiovascular Risk Assessment and Impact of Medications on Cardiovascular Disease in Inflammatory Bowel Disease. Inflamm Bowel Dis. 2021;27(7):1107-1115. Watermeyer G, Awuku Y, Fredericks E, Epstein D, Setshedi M, Devani S, Mudombi W, Kassianides C, Katsidzira L; Gastroenterology and Hepatology Association of sub-Saharan Africa (GHASSA). Challenges in the management of inflammatory bowel disease in sub-Saharan Africa. Lancet Gastroenterol. 2022;7(10):962-972. Christian M, Giovanni M, Torsten K, Mariangela A. Ultrasonography in inflammatory bowel disease - So far we are? United Eur Gastroent. 2022;10(2):225-232. Marsilio S. Differentiating Inflammatory Bowel Disease from Alimentary Lymphoma in Cats: Does It Matter? Vet Clin N Am-Small. 2021;51(1):93-109. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6921885","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":491444266,"identity":"bf9bf3f1-051a-4c9c-be7b-57b6bd3c334d","order_by":0,"name":"Le Xu","email":"","orcid":"","institution":"First Affiliated Hospital of Anhui Medical University","correspondingAuthor":false,"prefix":"","firstName":"Le","middleName":"","lastName":"Xu","suffix":""},{"id":491444267,"identity":"b6746ce2-5aaf-4ac7-b244-2a56a6c7deff","order_by":1,"name":"Xing Hu","email":"","orcid":"","institution":"First Affiliated Hospital of Anhui Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xing","middleName":"","lastName":"Hu","suffix":""},{"id":491444268,"identity":"cf6e1e1b-cb4a-4c46-bbcd-593b9319f8fd","order_by":2,"name":"Qingquan Bi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtUlEQVRIiWNgGAWjYBACA2YGhgNAWo6NvfkAaVqM+XiOJRCpBUonzpPIUSBOizk788bDBb+s09sYchgYflRsI6zFspmt4PDMvvTcNoazBxh7ztwmwmGHeQwO8/Yczm1j7EtgZmwjQUs6GzOPAQlaeH4cTmBjI1YL2C+8DemGbTxsCQeJ8os5/+HNn3n+WMvLz3988MGPCiK0gNzGwNjGDGYdIEo9WAvDH2ZiFY+CUTAKRsFIBAB9/zqygz7wmgAAAABJRU5ErkJggg==","orcid":"","institution":"School of Nursing, Anhui Medical University","correspondingAuthor":true,"prefix":"","firstName":"Qingquan","middleName":"","lastName":"Bi","suffix":""}],"badges":[],"createdAt":"2025-06-18 10:08:33","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6921885/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6921885/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87825912,"identity":"c7e5c45f-1be0-4317-8dd3-52e05746b399","added_by":"auto","created_at":"2025-07-29 11:50:25","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":52401,"visible":true,"origin":"","legend":"\u003cp\u003eNational standard \"Classification and grading of persons with disabilities\" for assessment.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6921885/v1/22cb7fd089e5d10fa9602882.png"},{"id":87825914,"identity":"88ab0cdd-fc34-47bf-9b2c-c458d6a0248a","added_by":"auto","created_at":"2025-07-29 11:50:25","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":51225,"visible":true,"origin":"","legend":"\u003cp\u003eEvaluation against IBD-ID\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6921885/v1/60ecc34ff5e13e254dce65b8.png"},{"id":87825923,"identity":"bc9b85f2-861a-44b1-95b9-8288be174b9a","added_by":"auto","created_at":"2025-07-29 11:50:26","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":47868,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of IBD-ID scores of patients.\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-6921885/v1/5e68251a2c748e29fd9be9fb.png"},{"id":87825919,"identity":"d74d7a68-c30d-470e-bfea-91ecd96e940a","added_by":"auto","created_at":"2025-07-29 11:50:26","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":50427,"visible":true,"origin":"","legend":"\u003cp\u003eROC curve of IBD-ID score to evaluate the degree of disability of IBD patients.\u003c/p\u003e","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-6921885/v1/83fc91a1c6c6df810e1ca712.png"},{"id":93380872,"identity":"207a86fa-6c17-4889-8fc1-39d0c65b4a3b","added_by":"auto","created_at":"2025-10-13 08:47:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1285053,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6921885/v1/088341cf-9497-423b-b04d-015d96a5fa07.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Multivariate logistic regression analysis of disability assessment and influencing factors in patients with inflammatory bowel disease using the disability index of inflammatory bowel disease: implications for prevention and treatment of inflammatory bowel disease","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInflammatory bowel disease (IBD) is a global disease, including Crohn's disease (CD), Ulcerative colitis (UC), and undetermined IBD (IBD-U), which has certain influence on intestinal mucosa, is a series of nonspecific gastrointestinal diseases characterized by chronic recurrent inflammation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. During the past few decades, IBD incidence has steadily increased worldwide [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. China has experienced an increase in the incidence of inflammatory bowel disease (IBD) over the last 20 years, with IBD patients exceeding 1.5\u0026nbsp;million in 2025 [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. IBD is characterized by a variety of physical and psychological symptoms, with clinical signs such as abdominal pain, diarrhea, bloody stools, anorexia, weight loss, depression and anxiety [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. IBD is common in young adults, and the onset age is gradually younger. Recurrent episodes of IBD can have a negative physical, psychological, family, economic and social impact on patients, reducing their personal life quality, work and relationships [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIBD can noticeably affect the life quality of patients, and early diagnosis and treatment are key to controlling the progression of the disease. Therefore, the risk factors for disability in IBD are very essential and will help to improve the management of those at risk, thus reducing morbidity and improving the life quality of patients [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Disability is the experience of physical function and structure damage, limited activity and limited participation in the interaction with environmental factors, which refers to the objective issues that patients may exist in different fields [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Most patients develop the disease at a young age, with repeated episodes of cumulative bowel damage, various extra-intestinal manifestations and adverse consequences of treatment, all of which can lead to disability [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Compared with patients with ulcerative colitis, patients with Crohn's disease are more restricted in their daily life, especially in the fields of interpersonal relationships, activities and participation [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The goals of treatment for IBD range from symptom control to complete control of the disease in the pursuit of improving the patient's life quality, improving prognosis and reducing the risk of disability [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In 2011, the inflammatory Bowel Disease Disability Index (IBD-DI) was developed based on the World Health Organization (WHO) International Classification of function, international classification of functioning of disability and health (ICF) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], the first tool specifically used to assess related disabilities in patients with IBD. Currently, most attention to patient self-reported outcomes focuses on the patient's life quality. Life quality is the subjective experience of the limitations imposed by the disease, rather than the limitations being assessed. In other words, disability refers to the objective limitations that patients may have in different areas, whereas life quality refers to how these limitations are perceived subjectively by the patient. The life quality is subjective and related to a person's coping strategies and cognitive level, while disability reflects the objective loss of personal function and the cost of disease to society. At present, there are few reports on using IBD-DI to evaluate and analyze the influencing factors of disability in patients with IBO, and the application value of IBD-DI and the risk factors of disability in IBD patients are not clear. It is necessary to carry out further research. This study specifically discussed the clinical value of IBD-DI in evaluating disability in IBD patients, and used multi-factor logistic regression to analyze the risk factors of disability in IBD patients, so as to offer reference to prevent and treat IBD clinically.\u003c/p\u003e"},{"header":"Patients and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e1.1 General information\u003c/h2\u003e\u003cp\u003eDuring February 2019 to June 2022, 290 patients with IBD cured in our hospital were evaluated according to the national standard \"International Classification of functional Disability and Health\" [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. There were 87 patients without disabilities as the control group and 203 patients with disabilities as the study group. The general data of all patients are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. All participants signed the informed consent form for this study, which was approved by our hospital's Medical Ethics Council.\u003c/p\u003e\u003cp\u003eInclusion criteria: 1) all cases met the diagnostic criteria of IBD [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], and the diagnosis time was more than 3 months; 2) the patient had reached the age of 18 years; 3) there were no other serious diseases and no serious mental disorders; 4) subjects had normal communication and comprehension skills and were able to complete the questionnaire alone or with the help of others; 5) upon signing the informed consent form, patients agreed to take part in the study.\u003c/p\u003e\u003cp\u003eExclusion criteria: 1) those who were unwilling to participate in this study; 2) those who could not understand the contents of the questionnaire; 3) those were under the age of 18 years; 4) those with other serious diseases such as chronic obstructive pulmonary disease, severe lung infections, cardiac insufficiency, severe liver and kidney insufficiency, diabetes mellitus, hyperthyroidism, severe mental disorders, etc.\u003c/p\u003e\u003cp\u003e The Clinical Technology Application Ethics Committee of the First Affiliated Hospital of Anhui Medical University approved this study protocol, which was in accordance with the Declaration of Helsinki. Patients gave written informed consent.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTreatment methods\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAccording to the \"General data questionnaire\" filled in by the patients, the general data of all selected patients were harvested, containing the frequency of physical exercise, the length of physical exercise, age, sex, educational level, average annual family income, marital status, whether to work, body mass index (BMI), residence, smoking history, drinking history. The disease characteristics of the two groups were recorded and compared, such as the course of disease, the age of diagnosed disease, the history of operation, the history of total enteral nutrition, the history of medication and so on.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e1.2 Observation index\u003c/h2\u003e\u003cp\u003eThe ICF provides a comprehensive WHO standard that can classify and describe the function, disability and health of any patient. Based on ICF, the disability index-IBD-DI was developed to evaluate the degree of disability in IBD patients. The complete development process of the scale was published in GLT magazine in 2011. According to the relevant literature [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], the items of the 5-point Likert scale of IBD-DI were counted as 0Mur4, the binary items as \"No\" = 0, \"Yes\" = 4, BMI\u0026thinsp;\u0026gt;\u0026thinsp;18.5 as 0, and BMI\u0026thinsp;\u0026le;\u0026thinsp;18.5 as 4. The score of diarrheas is as follows: \"0 times\" = 0, \"1\u0026ndash;7 times\" = 1, \"8\u0026ndash;18 times\" = 2 points, \"19\u0026ndash;29 times\" = 3 points,\"\u0026ge; 30 times\" = 4 points; The score of hematochezia is as follows: \"None\" =0, \"Light\" =2, \"Heavy\" =4. Then, sum the scores of all the items, and re-score the total score of IBD-DI with the total score \u0026times;100/(p\u0026times;4), with range from 0-100 scores, where p value is the number of items answered. The higher the score of IBD-DI, the higher the degree of disability. IBD-DI score was performed on the day of admission or the next day (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eChinese version of IBD-DI scoring method\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTopic type\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTitle number\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScoring method\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5-point Likert scale item\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u0026ndash;4 points\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFecal frequency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 times\u0026thinsp;=\u0026thinsp;0 points, 1\u0026ndash;7 times\u0026thinsp;=\u0026thinsp;1 points, 8\u0026ndash;18 times\u0026thinsp;=\u0026thinsp;2 points, 19\u0026ndash;29 times\u0026thinsp;=\u0026thinsp;3 points, \u0026ge;\u0026thinsp;30 times\u0026thinsp;=\u0026thinsp;4 points\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026gt;18.5kg/m2\u0026thinsp;=\u0026thinsp;0 points, \u0026le;\u0026thinsp;18.5kg/m2\u0026thinsp;=\u0026thinsp;4 points\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBinary item\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15、17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u0026thinsp;=\u0026thinsp;0 points, Yes\u0026thinsp;=\u0026thinsp;4 points\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlood in stool\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNone\u0026thinsp;=\u0026thinsp;0 points, Light\u0026thinsp;=\u0026thinsp;2 points, Heavy\u0026thinsp;=\u0026thinsp;4 points\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e1.3 Statistical analysis\u003c/h2\u003e\u003cp\u003eThe data were analyzed and processed by SPSS21.0 statistical software. In order to perform statistical analysis, the measurement data were first analyzed for normal distribution and variance homogeneity. A (\u0026plusmn;\u0026thinsp;s) symbol is used to indicate measurements with a normal distribution or approximate normal distribution. The group was compared using a paired t-test, while the two groups were compared using an independent sample t-test. The n (%) was adopted to represent the counting data, and χ 2 test was adopted. IBD-ID rating values were analyzed by receiver operating characteristic curve (ROC), and risk factors for disability in IBD patients were analyzed by Logistic ITC multivariate regression, with P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicating a statistically noticeable difference.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Division of disability degree\u003c/h2\u003e\u003cp\u003eAmong the 290 patients, all completed the evaluation of IBD-DI and national standard \"Classification and grading of Disability\". According to the classification and classification of disabled persons according to the national standard, 203 patients had varying degrees of disability, and 200 patients had varying degrees of disability according to IBD-DI criteria. All the data results are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Comparison of general data\u003c/h2\u003e\u003cp\u003eNo noticeable difference was found in marital status, BMI index, residence, smoking and drinking history (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). There were noticeable differences in age, sex, education level, average annual family income, work or not, frequency and duration of physical exercise (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). You can see all the data results in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe general data\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProject\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;87)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eResearch group(n\u0026thinsp;=\u0026thinsp;203)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eχ2/t\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34.93\u0026thinsp;\u0026plusmn;\u0026thinsp;2.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41.93\u0026thinsp;\u0026plusmn;\u0026thinsp;2.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e158.693\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender (male / female)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36/51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e154/49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e32.052\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003edegree of education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e23.856\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIlliterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1(1.15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(2.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7(8.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16(7.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJunior middle school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11(12.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e74(36.45)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ehigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26(29.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59(29.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCollege or above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42(48.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48(23.65)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAverage annual household income\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e60.166\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u0026ndash;4 thousand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1(1.15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24(11.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u0026ndash;10 thousand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8(9.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37(18.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u0026ndash;15 thousand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16(18.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e94(46.31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;15 thousand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62(71.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48(23.65)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.767\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8(9.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26(12.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e79(90.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e177(87.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork (yes / no)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e71/16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e107/96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20.156\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrequency of physical exercise (every week / time)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e76.120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8(9.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23(11.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30(34.48)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e161(79.31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49(56.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19(9.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe length of each physical exercise(hours)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e31.739\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0-0.5h\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8(9.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23(11.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0.6h-1h\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e29(33.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76(37.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1.1-2h\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19(21.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85(41.87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;2h\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31(35.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19(9.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI(kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23.44\u0026thinsp;\u0026plusmn;\u0026thinsp;2.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.196\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ehome place\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33(37.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e72(35.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54(62.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e131(64.53)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38(43.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e92(45.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHistory of drinking\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40(45.98)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e110(54.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.644\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Comparison of disease characteristics\u003c/h2\u003e\u003cp\u003eNo noticeable difference was found in the characteristics of parenteral diseases, enteral nutrition history, use of immunosuppressants, use of 5-aminosalicylicacidome 5-Methyl ASA, use of traditional Chinese medicine and no use of drugs (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). There were noticeable differences in age of diagnosis, history of operation, use of corticosteroids and biological agents (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). You can see all the data results in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe disease characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProject\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;87)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eResearch group(n\u0026thinsp;=\u0026thinsp;203)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eχ2/t\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCourse of disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e31.606\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge of diagnosed disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38.59\u0026thinsp;\u0026plusmn;\u0026thinsp;4.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13.255\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e94.427\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39(44.83)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5(2.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerianal operation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8(9.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68(33.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntestinal operation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23(26.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e106(52.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17(19.54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24(11.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAccompanied by extraintestinal diseases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25(28.74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e69(33.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.767\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHistory of total enteral nutrition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45(51.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e129(63.55)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.546\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGlucocorticoid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40(45.98)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e147(72.41)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e18.584\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eImmunosuppressants\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26(29.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85(41.87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.703\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5-ASA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e58(66.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e152(74.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.055\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBiological agents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51(58.62)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e148(72.91)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.772\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraditional Chinese medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24(27.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e135(66.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e37.239\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnused medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8(9.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27(13.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.976\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.05\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Comparison of IBD-DI score\u003c/h2\u003e\u003cp\u003eThe IBD-DI score of the study group was noticeably higher (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). You can see all the data results in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e2.5 ROC curve of IBD-DI score for evaluating disability degree of IBD patients\u003c/h2\u003e\u003cp\u003eThe Area Under Curve (AUC) of IBD-DI score in evaluating the degree of disability of patients with IBD was 0.842, and the 95% confidence interval (95% CI) was 0.758 to 0.925. The value of IBD-DI score in evaluating the degree of disability of patients with IBD was high (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e2.6 Risk factors of disability in patients with IBD\u003c/h2\u003e\u003cp\u003eAge, gender, education, mean annual household income, job, frequency of physical activity, duration of physical activity, duration of illness, age at diagnosis, history of surgery, glucocorticoid use, biologic use and IBD-DI score were the independent variables, with disability as the dependent variable (yes\u0026thinsp;=\u0026thinsp;1, no\u0026thinsp;=\u0026thinsp;0). The allocation table is shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Logistic regression analysis showed that age, average annual family income, work, duration of physical exercise, age of diagnosed disease, history of operation and IBD-DI score were the risk factors for disability in patients with IBD. You can see all the data results in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssignment table of independent variables\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndependent variable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAssignment\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIndependent variable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAssignment\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eContinuous variable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCourse of disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eContinuous variable\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u0026thinsp;=\u0026thinsp;1, Female\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAge of diagnosed disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eContinuous variable\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003edegree of education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSenior high school and below =\u0026thinsp;1, College or above =\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSurgical history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1, None\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAverage annual household income\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;150,000 per year\u0026thinsp;=\u0026thinsp;1,, \u0026gt;150,000/year\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUsed glucocorticoid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1, None\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u0026thinsp;=\u0026thinsp;1, Yes\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUsed biological agents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u0026thinsp;=\u0026thinsp;1, None\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrequency of physical exercise\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;3 times/week\u0026thinsp;=\u0026thinsp;1, \u0026gt;3 times/week\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIBD-DI Scoring\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eContinuous variable\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe length of each physical exercise\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;2h\u0026thinsp;=\u0026thinsp;1, \u0026gt;2h\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAnalysis of risk factors of disability in patients with IBD\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eS.E\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eChi-square value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eOR\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e95% CI for OR\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.855\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11.291\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2.113\u0026ndash;60.328\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender (male / female)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.842\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.834\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.878\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.230-32.351\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDegree of education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.953\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.052\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.446\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.063\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e7.050\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.897\u0026ndash;55.419\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAverage annual household income\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.844\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.316\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e34.052\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.322\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e3.403\u0026ndash;11.744\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.943\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.244\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.936\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.568\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.592\u0026ndash;4.142\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrequency of physical exercise\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.391\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.723\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.701\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.054\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.974\u0026ndash;16.578\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe length of each physical exercise\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.844\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.245\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.867\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.326\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.439\u0026ndash;3.759\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCourse of disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.984\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.330\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.547\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.459\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.675\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.197\u0026ndash;36.263\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge of diagnosed disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.982\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.331\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.802\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.670\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.395\u0026ndash;5.108\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.053\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.324\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.563\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.866\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1.519\u0026ndash;5.409\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGlucocorticoid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.943\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.842\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.254\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.263\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.568\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.493\u0026ndash;13.347\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBiological agents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.313\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.832\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.490\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.115\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.717\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.728\u0026ndash;18.986\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIBD-DI Scoring\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.845\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.312\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e34.969\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.328\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e3.433\u0026ndash;11.664\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIncreasing every year in recent years, IBD is a global condition that is more prevalent in western countries [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In the past few decades, the prevalence rate in countries or regions such as South Korea, Japan, India and China is getting higher and higher, and the incidence population has shown a younger trend [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. There are differences in geographical distribution, age and sex among the subtypes of IBD. Of 447 French patients with IBD who participated in the IBD-Disk cohort study, 70.9% had Crohn's disease [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The clinical data of some scholars on the Chinese version of IBD-DI show that Crohn's disease accounts for the majority of patients with IBD [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In total, 63 patients had ulcerative colitis while 107 had Crohn's disease. Up to 73.2% of this study's patients had ulcerative colitis, which is consistent with the epidemiology and regional distribution of IBD in China. The prevalence rate of ulcerative colitis in northern China is higher than that in southern China. Three one-year prospective IBD epidemiological studies based on urban population show that the incidence of ulcerative colitis is higher compared to Crohn's disease in some areas of northern China [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. IBD damages the social and functional ability of patients by affecting their physical and emotional health, and then has an important impact on their health status and life quality [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Disability is defined as an abnormality or loss of anatomical and physiological functions of the human body, such as various physical, psychological and mental disorders or losses and congenital abnormalities. Disability can result in long-term, persistent or permanent physical impairment and affect physical activity, daily living and social communication [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. With the change of treatment mode, patients' requirements for life quality are gradually increasing, and the prevention of intestinal injury and disability has become a new treatment goal. Crohn and ulcerative colitis have high disability rates and will increase the burden of disease. In the last decade, more objective tools have been found to measure disability in order to better assess it [\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and to prevent its onset early.\u003c/p\u003e\u003cp\u003eIBD-DI is the first specific index to be adopted as a tool to measure disability in IBD, and its complete development process was published in GUT in 2011 [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The formulation and development of IBD-ID is a long-term and gradual process. First, a large expert survey was conducted with 125 experts from 37 countries, including all health professionals working with people with IBD, such as doctors, nurses, psychologists and dieticians [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. A cross-sectional study involving three different centers was also conducted, one in the United States and two in Europe [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. On the basis of systematic literature review, qualitative research, expert investigation and cross-sectional research, different measurement standards are selected from \"ICF\". In 2010, 20 experts from 17 countries participated in a consensus meeting held in Switzerland to develop the final outcome of the IBD-ID [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The IBD-ID contains a total of 28 questions. The first question asks about the patient's general health, 17 questions include the severity of the patient's limitations in terms of sleep and energy, mood, body image, abdominal pain, bowel movements, participation in social activities, work and education, 8 questions relate to environmental factors, to positive or negative effects of medication, food, family and medical personnel, and the last two questions relate to social security and the health care system [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eCurrently, the IBD-ID has been adapted from its original English version to French, Portuguese, Australian, Dutch, Belgian, Canadian, Spanish, Singaporean and Chinese versions, and the index has proven to be a reliable and effective tool through clinical data. It can help clinicians guide different treatment decisions [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Foreign scholars translated IBD-DI into Portuguese, and two researchers investigated IBD patients at baseline, 4 weeks and 4 months later. Analyzing the factors, we determined that the scale is singular and reduced it to 14 items as a result [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. In Portuguese IBD patients, the Portuguese version of IBD-DI is reliable, effective, responsive, and understandable [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. In collaboration with the original developers of the IBD-DI, Gower-Rousseau et al. translated the original IBD-DI into French and then surveyed a random sample of 200 adult IBD patients diagnosed with IBD in the French population register [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The resulting French version of IBD-DI includes 14 questions with scores ranging from 0 to 100, with an average score of 35.3, the intra-group correlation coefficient was 0.91 and the internal consistency Cronbach's a was 0.86. A prospective study of 322 patients with IBD using the Korean version of the IBD-DI by foreign scholars found that IBD-DI scores for UC (r\u0026thinsp;=\u0026thinsp;0.636, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and CD (r\u0026thinsp;=\u0026thinsp;0.711, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) correlated with CUCQ-8 scores [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Foreign scholars translated the Danish version of the IBD-DI with a Cronbach'a of 0.91 for all 14 items of the questionnaire and a strong correlation between the IBD-DI and SIBDO (Person correlation coefficient = -0.81) [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. The internal consistency score of IBD-DI is \"good\", the reliability within observers is \"good\", the reliability among observers is \"excellent\", and the structural validity is \"moderately strong\" to \"very strong\". The structural validity is mainly single-dimensional and has good responsiveness, but its interpretability is only useful in groups.\u003c/p\u003e\u003cp\u003eUp to now, there is little research on IBD-DI in China. A New Zealand study has suggested that the self-report of the disability index of IBD is a simple self-report tool for measuring the disability of IBD, which can be applied to patients' own clinical practice [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. As science and technology and the improvement of people's lives have developed, the requirements for questionnaires have gradually increased. Not only does the IBD-DI dynamically assess a patient's impact on different aspects of their lives, it may also serve as a clinical decision-making tool for gastroenterologists [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eCombined with the results of this study, all 290 patients have completed the evaluation of IBD-DI and the national standard International Classification of Functional Disability and Health. Among 290 patients, 203 patients have different degrees of disability; According to the IBD-DI standard, 200 patients have different degrees of disability. It can be seen that there is little difference between IBD-DI and the International Classification of Functional Disability and Health. The AUC of IBD-ID score in evaluating the degree of disability of patients with IBD is 0.842( 95%CI\u0026thinsp;=\u0026thinsp;0.758\u0026ndash;0.925). The value of IBD-ID score in evaluating the degree of disability of patients with IBD is high. In our research, 70.0% of IBD patients have different degrees of disability. It can be seen that the incidence of disability in China's IBD population is very high. There are differences in age, sex, education level, average annual family income, whether to work, frequency of physical exercise and duration of physical exercise. There were noticeable differences in the age of diagnosis, surgical history, glucocorticoid use and biological preparation use. The IBD-ID score of the study group was noticeably higher. We found that age, average annual family income, work, length of physical exercise, age of diagnosed disease, surgical history and IBD-DI score were the risk factors of disability in patients with IBD. The elderly are more likely to become disabled due to their poor physical function. Non-working people are also more likely to become disabled due to their lack of exercise and inferior physical function to working people. In addition, low-income households are less concerned about their health, have less investment in health protection and are at higher risk of disability than higher income households. Additionally, people who are less physically active are naturally less fit than those who are more physically active and are therefore more likely to become disabled. The IBD-DI score is an important indicator of the degree of disability, so it is necessary to strengthen clinical observation and intervention for patients with high IBD-DI scores. Therefore, we should strengthen the attention and intervention of the above-mentioned high-risk groups, and take effective treatment measures to improve the length of each physical exercise, so as to reduce the long-term disability of patients. For those IBD patients with older age, lower average annual family income, shorter duration of physical exercise and history of gastrointestinal surgery, we should pay more attention to their disability risk. For those patients with IBD who are receiving total enteral nutrition, physical activity should be encouraged to reduce the degree of disability [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. In clinic, more attention should be paid to the disability risk of IBD patients with a longer course of disease [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Similarly, patients with IBD should be encouraged to take an active part in physical exercise. In short, these patients with high risk factors of disability should be closely monitored and followed up, and effective measures should be taken to intervene, which may be the best way to prevent disability and help patients return to normal life [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. The disability evaluation of IBD patients has been gradually accepted and valued by medical circles all over the world, which can be used in clinical and scientific research to guide clinical decision-making. At present, there is little research in this field in China. IBD-DI is used to evaluate the degree of disability of IBD patients in China and explore the related factors that can affect the degree of disability, which will promote the development of clinical medicine and optimize the allocation of medical resources in China [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Whether the scale can be widely used in clinical practice and whether there is long-term variability needs to be confirmed in a larger sample. It is anticipated that in the future it will be possible to evaluate the degree of disability of patients based on the IBD-DI, thus guiding clinical decision-making and enabling graded management of patients.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study confirmed that IBD-DI is a credible and effective tool for evaluating the degree of disability in Chinese patients with IBD, and can be adopted for clinical quantitative stratified management of patients with IBD. Age, average annual family income, work, length of physical exercise, age of diagnosed disease and history of operation were risk factors for disability in patients with IBD.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe confirm that we have read the Journal\u0026apos;s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone of the authors has any conflicts of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLe Xu and Xing Hu wrote the main manuscript text, Qingquan Bi offered references and reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThanks to Director Yanghua Tian , Director Ling Wei , and Director Juanjuan Zhang for providing the data and materials.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participat\u003c/strong\u003e\u003cstrong\u003ee\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from Clinical Technology Application Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Declaration of Helsinki).All participants signed the informed consent form for this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSeyedian SS, Nokhostin F, Malamir MD. 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Eur J Gastroen Hepat. 2020;32(11):1422-1431.\u003c/li\u003e\n\u003cli\u003eKudo T, Arai K, Uchida K, Tajiri H, Hokari R, Suzuki Y, Shimizu T. Very early-onset inflammatory bowel disease in Japan: A nationwide survey. J Gastroen Hepatol. 2021;36(1):151-155. \u003c/li\u003e\n\u003cli\u003eMasi L, Capobianco I, Magr\u0026igrave; C, Marafini I, Petito V, Scaldaferri F. MicroRNAs as Innovative Biomarkers for Inflammatory Bowel Disease and Prediction of Colorectal Cancer. Int J Mol Sci. 2022;23(14):7991.\u003c/li\u003e\n\u003cli\u003eDalzell AM, Ba\u0026apos;Ath ME. Paediatric inflammatory bowel disease: review with a focus on practice in low- to middle-income countries. Paediatr Int Child H. 2019;39(1):48-58. \u003c/li\u003e\n\u003cli\u003ePark J, Park S, Lee SA, Park SJ, Cheon JH. Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management. Korean J Intern Med. 2021;36(5):1040-1048. \u003c/li\u003e\n\u003cli\u003eSinh P, Cross R. Cardiovascular Risk Assessment and Impact of Medications on Cardiovascular Disease in Inflammatory Bowel Disease. Inflamm Bowel Dis. 2021;27(7):1107-1115.\u003c/li\u003e\n\u003cli\u003eWatermeyer G, Awuku Y, Fredericks E, Epstein D, Setshedi M, Devani S, Mudombi W, Kassianides C, Katsidzira L; Gastroenterology and Hepatology Association of sub-Saharan Africa (GHASSA). Challenges in the management of inflammatory bowel disease in sub-Saharan Africa. Lancet Gastroenterol. 2022;7(10):962-972. \u003c/li\u003e\n\u003cli\u003eChristian M, Giovanni M, Torsten K, Mariangela A. Ultrasonography in inflammatory bowel disease - So far we are? United Eur Gastroent. 2022;10(2):225-232. \u003c/li\u003e\n\u003cli\u003eMarsilio S. Differentiating Inflammatory Bowel Disease from Alimentary Lymphoma in Cats: Does It Matter? Vet Clin N Am-Small. 2021;51(1):93-109.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"IBD-DI, IBD, Disability, IBD-DI score","lastPublishedDoi":"10.21203/rs.3.rs-6921885/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6921885/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThe clinical value of using inflammatory bowel disease disability index (IBD-DI) was explored to evaluate disability in patients with inflammatory bowel disease (IBD). IBD patients' disability risk factors were analyzed using multivariate logistic regression analysis in order to provide clinical guidance on prevention and treatment of IBD.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eFrom February 2019 to June 2022, 290 patients with IBD cured in our hospital. There were 87 patients without disabilities as the control group and 203 patients with disabilities as the study group. The general data were compared to analyze the clinical value of IBD-DI in evaluating the disability of IBD patients. To analyze the risk factors for disability in patients with IBD, multivariate logistic regression was used.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAmong the 290 patients, 203 patients had different degrees of disability according to the national standard \"Classification and Grading of Disabled Persons\". There were statistically noticeable differences in age, sex, education level, average annual family income, whether to work, frequency of physical exercise and duration of physical exercise. There were noticeable differences in diagnosis age, surgical history, glucocorticoid use and biological agents use (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The IBD-DI score of the study group was noticeably higher (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The area under the curve (AUC) of IBD-DI score to evaluate the disability degree of IBD patients was 0.842, and 95% confidence interval (95%CI) was 0.758\u0026ndash;0.925. Logistic regression analysis indicated that age, average annual family income, work, length of physical exercise each time, age of diagnosed disease, surgical history and IBD-DI score were the risk factors of disability in patients with IBD.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eA validated and reliable tool for assessing disability in Chinese patients with IBD is the IBD-DI. Patient age, average annual household income, duration of work and physical activity, age at diagnosis of disease, surgical history and IBD-DI score are risk factors for disability in patients with IBD. It is anticipated that in the future it will be possible to evaluate the degree of disability of patients based on the IBD-DI to guide clinical decision making and enable stratified management of patients.\u003c/p\u003e","manuscriptTitle":"Multivariate logistic regression analysis of disability assessment and influencing factors in patients with inflammatory bowel disease using the disability index of inflammatory bowel disease: implications for prevention and treatment of inflammatory bowel disease","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-29 11:50:21","doi":"10.21203/rs.3.rs-6921885/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"39becf49-6184-4fad-b34d-617e8650c4f9","owner":[],"postedDate":"July 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-13T08:30:55+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-29 11:50:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6921885","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6921885","identity":"rs-6921885","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}