Amiot Aurelien, Chaibi Sayma, Bouhnik Yoram, Serrero Melanie, Filippi Jerome, Roblin Xavier, Bourrier Anne, Bouguen Guillaume, Franchimont Denis, Savoye Guillaume, Buisson Anthony, Louis Edouard, Nancey Stephane, Abitbol Vered, Reimund Jean-Marie, DeWit Olivier, Vuitton Lucine, Mathieu Nicolas, Peyrin-Biroulet Laurent, Gilletta Cyrielle, Allez Matthieu, Viennot Stephanie, Le Berre Catherine, Dib Nina, Brixi Hedia, Painchart Claire, Plastaras Laurianne, Altwegg Romain, Fumery Mathurin, Caillo Ludovic, Laharie David, Nachury Maria
Department of Gastroenterology, Hopitaux Universitaires Bicêtre, AP-HP, Université Paris Saclay, INSERM, Centre for Research in Epidemiology and Population Health, Le Kremlin Bicêtre, France.
Department of Gastroenterology, Henri Mondor Hospital, Paris Est-Créteil Val de Marne University, Creteil, France.
J Crohns Colitis. 2023 Oct 20;17(9):1418-1425. doi: 10.1093/ecco-jcc/jjad060.
Fatigue is commonly reported by patients with inflammatory bowel disease [IBD], but the determinants of IBD-related fatigue have yet to be determined.
To identify the factors associated with fatigue in a large population of patients with IBD.
Fatigue and nine other IBD-related disability dimensions were assessed in a cohort of 1704 consecutive patients with IBD using the IBD-disk questionnaire in a cross-sectional survey of 42 French and Belgian centres. Fatigue and severe fatigue were defined as energy subscores >5 and >7, respectively. Determinants of fatigue were assessed using univariate and multivariate analyses (odds ratios [ORs] are provided with 95% confidence intervals).
The prevalence rates of fatigue and severe fatigue were 54.1% and 37.1%, respectively. Both fatigue and severe fatigue were significantly higher in patients with active disease than in patients with inactive disease [64.9% vs 44.7% and 47.4% vs 28.6%, respectively; p < 0.001 for both comparisons]. In the multivariate analysis stratified by age, sex, type of IBD and IBD activity, fatigue was associated with age >40 years (OR = 0.71 [0.54-0.93]), female sex (OR = 1.48 [1.13-1.93]) and IBD-related sick leave (OR = 1.61 [1.19-2.16]), and joint pain (OR = 1.60 [1.17-2.18]), abdominal pain (OR = 1.78 [1.29-2.45]), regulating defecation (OR = 1.67 [1.20-2.32]), education and work (OR = 1.96 [1.40-2.75]), body image (OR = 1.38 [1.02-1.86]), sleep (OR = 3.60 [2.66-4.88]) and emotions (OR = 3.60 [2.66-4.88]) subscores >5.
Determinants of fatigue are not restricted to IBD-related factors but also include social factors, sleep and emotional disturbances, thus supporting a holistic approach to IBD patient care.
炎症性肠病(IBD)患者普遍报告有疲劳症状,但IBD相关疲劳的决定因素尚未确定。
确定大量IBD患者中与疲劳相关的因素。
在一项对42个法国和比利时中心进行的横断面调查中,使用IBD-disk问卷对1704例连续的IBD患者队列进行了疲劳及其他9个与IBD相关的残疾维度评估。疲劳和严重疲劳分别定义为能量子评分>5分和>7分。使用单因素和多因素分析评估疲劳的决定因素(优势比[OR]提供95%置信区间)。
疲劳和严重疲劳的患病率分别为54.1%和37.1%。活动期疾病患者的疲劳和严重疲劳发生率均显著高于非活动期疾病患者[分别为64.9%对44.7%和47.4%对28.6%;两项比较p均<0.001]。在按年龄、性别、IBD类型和IBD活动分层的多因素分析中,疲劳与年龄>40岁(OR = 0.71 [0.54 - 0.93])、女性(OR = 1.48 [1.13 - 1.93])、IBD相关病假(OR = 1.61 [1.19 - 2.16])、关节痛(OR = 1.60 [1.17 - 2.18])、腹痛(OR = 1.78 [1.29 - 2.45])、排便调节(OR = 1.67 [1.20 - 2.32])、教育和工作(OR = 1.96 [1.40 - 2.75])、身体形象(OR = 1.38 [1.02 - 1.86])、睡眠(OR = 3.60 [2.66 - 4.88])和情绪(OR = 3.60 [2.66 - 4.88])子评分>5分有关。
疲劳的决定因素不仅限于IBD相关因素,还包括社会因素、睡眠和情绪障碍,因此支持对IBD患者进行整体护理。