Feagins Linda A, Moore Page, Crabtree Margaux M, Eliot Melissa, Lemay Celeste A, Loughlin Anita M, Gaidos Jill K J
Division of Gastroenterology and Hepatology, Dell Medical School at the University of Texas at Austin, Austin, TX, USA.
CorEvitas LLC, Waltham, MA, USA.
Crohns Colitis 360. 2024 Dec 21;7(1):otae073. doi: 10.1093/crocol/otae073. eCollection 2025 Jan.
Fatigue is commonly reported in patients with Crohn's disease (CD) and ulcerative colitis (UC), including patients with inactive disease. We explored the impact of fatigue on healthcare utilization (HCU) and work productivity and activity impairment (WPAI).
Data collected between 2017 and 2022 were analyzed from the CorEvitas IBD Registry. We compared HCU and WPAI among subjects with high fatigue (PROMIS ≥55) versus low fatigue at enrollment and subjects whose fatigue score worsened or persisted versus low fatigue at 6 months. HCU was defined as an inflammatory bowel disease-related hospitalization or emergency room visit. WPAI included presenteeism, absenteeism, and lost WPAI. Logistic regression analysis was performed.
Study patients (640 CD, 569 UC) reported high rates of fatigue, 47% in CD and 38% in UC, that persisted at least 6 months in 88%-89% of patients. Patients with UC with high fatigue had 3-fold higher rates of HCU and 2-3-fold more absenteeism and activity impairment than patients with low fatigue. Patients with CD with high fatigue had no difference in HCU but did experience 2-4-fold more absenteeism, presenteeism, work productivity loss, and activity impairment. On subgroup analysis of patients in remission, those with high fatigue did not have higher rates of HCU but continued to have higher rates of WPAI.
Fatigue is associated with an increase in HCU only in the setting of concomitantly active disease. On the other hand, fatigue is associated with a negative impact on WPAI in the setting of both active and inactive disease.
克罗恩病（CD）和溃疡性结肠炎（UC）患者，包括疾病处于非活动期的患者，普遍报告存在疲劳症状。我们探讨了疲劳对医疗保健利用率（HCU）、工作效率及活动受限（WPAI）的影响。
对CorEvitas IBD注册中心2017年至2022年收集的数据进行分析。我们比较了入组时疲劳程度高（患者报告结果测量信息系统[PROMIS]≥55）与疲劳程度低的受试者之间的HCU和WPAI，以及疲劳评分在6个月时恶化或持续的受试者与疲劳程度低的受试者之间的HCU和WPAI。HCU定义为与炎症性肠病相关的住院或急诊就诊。WPAI包括出勤主义、旷工和WPAI损失。进行了逻辑回归分析。
研究患者（640例CD、569例UC）报告的疲劳发生率较高，CD患者中为47%，UC患者中为38%，88%-89%的患者疲劳症状持续至少6个月。疲劳程度高的UC患者的HCU发生率比疲劳程度低的患者高3倍，旷工和活动受限则多2-3倍。疲劳程度高的CD患者的HCU无差异，但旷工、出勤主义、工作效率损失和活动受限确实多2-4倍。在缓解期患者的亚组分析中，疲劳程度高的患者的HCU发生率没有更高，但WPAI发生率仍然较高。
仅在伴有活动性疾病的情况下，疲劳才与HCU增加相关。另一方面，在活动性疾病和非活动性疾病的情况下，疲劳均与对WPAI的负面影响相关。
