Gastroenterology

Gastroenterology

Volume 122, Issue 5, May 2002, Pages 1235-1241
Gastroenterology

Clinical Research
The true impact of fatigue in primary biliary cirrhosis: A population study☆

https://doi.org/10.1053/gast.2002.32993Get rights and content

Abstract

Background & Aims: Patient surveys suggest that fatigue is a common problem in primary biliary cirrhosis (PBC). The actual extent of the problems caused by fatigue in PBC has yet to be determined as previous studies addressing this question have tended to use selected patient subgroups and subjective or non-quantitative fatigue assessment tools. Here, we have attempted to more accurately assess the extent of fatigue in PBC, and the specificity of the symptom for this disease, by the application of an objective measure of fatigue impact (the fatigue impact score [FIS]) to a geographically based patient cohort, age- and sex-matched normal controls, and chronic liver disease controls. Methods: Postal completion of the FIS and linked symptom assessment tools. Results: Median FIS was significantly higher in patients (n = 136) than community controls (40 [0–138] vs. 28 [0–156]; P < 0.0001) and chronic liver disease controls (n = 38) (20.5 [0–145]; P < 0.05). Fatigue scores in the 11 patients who had undergone liver transplantation (median 3.5 years previously) were the same as those in non-transplanted patients with advanced disease. Conclusions: Fatigue is a significant and specific problem in PBC. It is not, however, universal and affects fewer patients than has previously been thought to be the case based on data from selected patient cohorts. This definition of the “normal range” for fatigue in PBC will assist in future studies of etiology and therapy.

GASTROENTEROLOGY 2002;122:1235-1241

Section snippets

Study design and setting

This was a geographically based, controlled study of the impact of fatigue in PBC performed in the North East of England. In addition to comparison with normal community case-controls, fatigue impact in PBC was also compared with that seen in a non-PBC chronic liver disease control group (a comprehensive cohort of patients from the same geographical area previously identified as having AIH13). Previously described exhaustive case finding approaches have allowed the identification of extant

Fatigue impact in PBC and community and chronic liver disease controls

Symptom assessment tools were sent to all 194 PBC patients identified in the study area on the census date of December 31, 1999. Responses were received from 157 of 194 (81%). Of these assessment tools, 136 of 157 (87%) were satisfactorily completed. The PBC subjects who returned completed symptom assessment tools, and who were therefore included in the study, were found to be representative, as a group, of the study population as a whole. There were no statistically significant differences

Discussion

In this study, we have shown that the degree of fatigue experienced by a representative cohort of PBC patients is significantly greater than that experienced by age- and sex-matched community controls, and by a second control group of patients with AIH. Although the return of completed symptom assessment tools by the study PBC population was incomplete, the group returning assessment tools was found to be representative of the whole geographically defined study population with regard to both

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    • Cited by (0)

    ☆

    Address requests for reprints to: David E. J. Jones, M.D., Ph.D., Centre for Liver Research, 4th Floor William Leach Building, The Medical School, Framlington Place, Newcastle-upon-Tyne, NE2 4 HH, United Kingdom. e-mail: [email protected]; fax: 0191 222 0723.

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    Copyright © 2002 American Gastroenterological Association. Published by Elsevier Inc. All rights reserved.