Prevalence and Factors Associated with Fatigue in Patients with Inflammatory Bowel Disease: A Multicenter Study.
J Crohns Colitis. 2019 Feb 05;:
Authors: Chavarría C, Casanova MJ, Chaparro M, Barreiro-de Acosta M, Ezquiaga E, Bujanda L, Rivero M, Argüelles-Arias F, Martín-Arranz MD, Martínez-Montiel MP, Valls M, Ferreiro-Iglesias R, Llaó J, Moraleja-Yudego I, Casellas F, Antolín-Melero B, Cortés X, Plaza R, Pineda JR, Navarro-Llavat M, García-López S, Robledo-Andrés P, Marín-Jiménez I, García-Sánchez V, Merino O, Algaba A, Arribas-López MR, Banales JM, Castro B, Castro-Laria L, Honrubia R, Almela P, Gisbert JP
AIMS: To determine the prevalence of fatigue in patients with inflammatory bowel disease (IBD), to identify the factors associated with fatigue and its severity, to assess the impact of fatigue on quality of life (QoL) and to evaluate the relationship between fatigue and sleep disorders.
METHODS: Prospective multicenter study conducted at 22 Spanish centers. Consecutive patients followed at IBD Units were included. Fatigue was evaluated with the Fatigue Severity Scale (FSS), and the Fatigue Impact Scale (FIS). QoL and sleep quality were assessed using the IBD Questionnaire-Short Form (IBDQ-9) and the Pittsburgh Sleep Quality Index (PSQI), respectively.
RESULTS: Five hundred forty-four consecutive adult IBD patients were included (50% women, mean age 44 years, 61% Crohn’s disease). The prevalence of fatigue was 41% (95%CI=37%-45%). The variables associated with an increased risk of fatigue were: anxiety (OR=2.5, 95%CI=1.6-3.7), depression (OR=2.4, 95%CI=1.4-3.8), presence of extraintestinal manifestations (EIMs) (OR=1.7, 95%CI=1.1-2.6), and treatment with systemic steroids (OR=2.8, 95%CI=1.4-5.7). The presence of EIMs (regression coefficient, RC=8.2, 95%CI=2.3-14.2), anxiety (RC=25.8, 95%CI=20.0-31.5), depression (RC=30.6, 95%CI=24.3-37.0) and sleep disturbances (RC=15.0, 95%CI=9.3-20.8) were associated with severity of fatigue. Patients with fatigue had a significantly decreased IBDQ-9 score (p<0.001).
CONCLUSIONS: The prevalence of fatigue in IBD patients is remarkably high and has a negative impact on QoL. Therapy with systemic steroids is associated with an increased risk of fatigue. The severity of fatigue is associated with anxiety, depression, sleep disorders and the presence of EIMs. Fatigue was not associated with anemia, disease activity or anti-TNF therapy.
PMID: 30721954 [PubMed – as supplied by publisher]