Department of Paediatric Pulmonology and Allergy, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands.
Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Pediatr Allergy Immunol. 2024 Oct;35(10):e14262. doi: 10.1111/pai.14262.
Fatigue is a commonly reported clinical symptom, yet research on fatigue in children with severe asthma is missing. We aimed to explore the extent of fatigue in severe pediatric asthma and identify associated factors.
This study was conducted within the Pediatric Asthma Non-Invasive Diagnostic Approaches (PANDA), an observational cohort of 6- to 17-year-old Dutch children with severe asthma. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL™-MFS) was used to measure self-reported fatigue. Fatigue levels were compared with a general pediatric Dutch population using linear regression, and quantifying the prevalence of "fatigued" (-2 < Standard deviations [SD] ≤ -1) and "severely fatigued" (SD ≤ -2) children. Secondly, we performed linear regression analyses to explore whether fatigue levels were independently associated with asthma attacks, comorbidities, medication, pulmonary function, symptom control, and asthma-related quality of life (QoL).
Severe pediatric asthma patients (n = 78, mean age 11.8 ± 3.1 years) reported significantly more fatigue than Dutch peers (n = 328, mean age 11.8 ± 3.2 years) mean difference in z-score: -0.68; 95%CI -0.96, -0.40. In the severe asthma group, 28.2% scored as "fatigued" and 15.4% as "severely fatigued," compared with 14.0% and 3.4% in the general population. In pediatric asthma patients, asthma-related QoL (β = 0.77, p < .01, ΔR = .43), symptom control (β = 0.56, p < .01, ΔR = .24) and a dysfunctional breathing pattern (β = -0.36, p < .01, ΔR = .12) were most strongly associated with fatigue scores.
Fatigue is a common symptom in children with severe asthma and is associated with multiple clinical factors and patient-reported outcomes. It should be considered as an important treatment target.
疲劳是一种常见的临床症状，但关于严重哮喘儿童的疲劳研究却很少。我们旨在探讨严重儿科哮喘患者的疲劳程度，并确定相关因素。
本研究是在儿科哮喘无创诊断方法（PANDA）中进行的，该研究是一项针对 6 至 17 岁严重哮喘荷兰儿童的观察队列研究。使用儿科生活质量问卷多维疲劳量表（PedsQL™-MFS）来衡量自我报告的疲劳程度。使用线性回归将疲劳程度与一般儿科荷兰人群进行比较，并量化“疲劳”（-2<标准偏差 [SD]≤-1）和“严重疲劳”（SD≤-2）儿童的患病率。其次，我们进行了线性回归分析，以探讨疲劳水平是否与哮喘发作、合并症、药物、肺功能、症状控制和哮喘相关生活质量（QoL）独立相关。
严重儿科哮喘患者（n=78，平均年龄 11.8±3.1 岁）比荷兰同龄人（n=328，平均年龄 11.8±3.2 岁）报告的疲劳程度明显更高，z 分数差异的平均值为-0.68；95%CI-0.96，-0.40。在严重哮喘组中，28.2%的患者疲劳评分“疲劳”，15.4%的患者疲劳评分“严重疲劳”，而普通人群中这一比例分别为 14.0%和 3.4%。在儿科哮喘患者中，哮喘相关 QoL（β=0.77，p<0.01，ΔR=0.43）、症状控制（β=0.56，p<0.01，ΔR=0.24）和功能失调的呼吸模式（β=-0.36，p<0.01，ΔR=0.12）与疲劳评分的相关性最强。
疲劳是严重哮喘儿童的常见症状，与多种临床因素和患者报告的结果相关。应将其视为重要的治疗目标。
