P683 Risk factors for fatigue in IBD patients.
Sina, M.(1)*;Djegsi, A.(1);Pemaj, X.(1);Telaku, S.(2);Babameto, A.(1);Prifti, S.(1);
(1)University Hospital Center Mother Theresa, Internal Medicine/ Gastroenterology, Tirana, Albania;(2)UBD, Gastroenterology, Pristina, Kosovo;
Background
Fatigue is a common symptom, in IBD patients, ranging from 40% to 86% in patients with active disease, and 20% to 48% in those in remission. The aim was to determine the degree of fatigue and to identify possible factors associated to its presence in our patients.
Methods
Consecutive patients presented at our outpatient IBD clinic from 2021 to 2022 were included. Demographic data, disease activity scores, endoscopic scores, disease duration, localization, hospitalization, laboratory data, were collected for each patient. Working status was determined on the patient’s actual ability to work. Total Mayo score (TMS) and Crohn’s disease activity index (CDAI) were used to assess disease activity in patients with ulcerative colitis (UC) and Crohn’s disease (CD) respectively. Clinical remission was defined as TMS ≤ 2 points, or CDAI < 150 points. Presence of inflammation was defined C-reactive protein ≥ 5.1 mg/L. Presence of anxiety and depression was evaluated using Hospital Anxiety and Depression Scale HADS and fatigue was assessed with self-administered questionnaire IBD Fatigue Rating Scale (FRS). Based on FRS, 2 groups of patients were created: group A with slight to moderate fatigue (1-60 points) and group B patients with severe fatigue (61-120 points).
Results
A total of 48 IBD patients were included; mean age was 40.9±16.0 years, 60.4% females; 89.6% UC. Mean disease duration was 5±4.6 years. Of UC patients, 44.2% were in clinical remission, 16.3% had mild disease, 30.2% moderate disease, and 9.3% severe disease. Of CD patients, 40% were in clinical remission and 60% had active disease.
Severe fatigue was found in 8/48 (16.7%) of patients, and was significantly higher in those with active disease (p=0.039), presence of inflammation (p=0.018), and anxiety (p=0.059). Mean fatigue score was 35.4±22.4 points with no statistical difference between CD and UC (p=0.404). Higher fatigue scores were observed among patients with presence of active disease (p=0.036); among patients with higher TMS scores (p = 0.022); in patients with anxiety (p=0.01), and in patients with depression (p=0.004).
On multiple linear regression, only vitamin D levels and working status were associated with fatigue severity (p= 0.052; p= 0.049, respectively R2 =0.062).
Conclusion
Our study findings confirm that the most important factors associated with fatigue during IBD course, are disease activity, presence of inflammation, presence of anxiety and/or depression. Low vitamin D level and working status were predictive factors for fatigue severity. These results highlight the complexity and variability of fatigue in IBD patients.