Department of Rheumatology and Immunology, Medical School, University of Pécs, H-7632 Pécs, Hungary.
Institute of Bioanalysis, Medical School, University of Pécs, H-7624 Pécs, Hungary.
Int J Environ Res Public Health. 2022 Dec 31;20(1):771. doi: 10.3390/ijerph20010771.
(1) Background: Systemic sclerosis (SSc) is characterized by significant fatigue, causing diminished quality of life (QoL). The aim of this study was to examine fatigue levels and their associations with clinical factors and determine the minimal clinically important difference (MCID) value for the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-FS). (2) Methods: A total of 160 SSc patients and 62 individuals without SSc were followed-up over a 12-month period by measuring the FACIT-FS and the Visual Analogue Scale and the Short Form 36 Vitality Score analyzing changes in exhaustion. (3) Results: Fatigue was strongly correlated with HRQoL, level of pain, emotional disorders, physical capability and functionality. The MCID values for FACIT-FS were calculated as -3 for deterioration and +4 for improvement after a 12-month follow-up. The predictors of improvement of fatigue from baseline parameters were the significant disease activity, the patients' poorer functionality and the short disease duration. Patients with scleroderma-related interstitial lung disease at baseline had approximately tripled risks for worsening fatigue. The independent influential factors regarding the changing of FACIT-FS were improving or worsening in the same direction in reference to physical condition, gastrointestinal and emotional factors. (4) Conclusions: Fatigue is a multi-dimensional symptom, which is strongly correlated to HRQoL. MCID values of FACIT-FS can be useful tools in monitoring the changes of HRQoL in clinical trials and in daily practice among patients with SSc.
(1) 背景:系统性硬化症(SSc)的特征是显著的疲劳,导致生活质量(QoL)下降。本研究旨在检查疲劳水平及其与临床因素的关系,并确定慢性疾病治疗疲劳量表(FACIT-FS)的最小临床重要差异(MCID)值。
(2) 方法:对 160 例 SSc 患者和 62 名无 SSc 的个体进行了为期 12 个月的随访,通过测量 FACIT-FS 和视觉模拟量表以及短表 36 活力评分,分析疲劳的变化。
(3) 结果:疲劳与 HRQoL、疼痛程度、情绪障碍、身体能力和功能高度相关。FACIT-FS 的 MCID 值为-3(恶化)和+4(改善),随访 12 个月后。疲劳改善的预测因素是疾病活动度显著、患者功能更差和疾病持续时间短。基线时有系统性硬化症相关间质性肺病的患者,疲劳恶化的风险约增加两倍。FACIT-FS 变化的独立影响因素是身体状况、胃肠道和情绪因素的改善或恶化方向相同。
(4) 结论:疲劳是一种多维症状,与 HRQoL 密切相关。FACIT-FS 的 MCID 值可作为监测临床试验和 SSc 患者日常实践中 HRQoL 变化的有用工具。