Evaluation of fatigue in U.S. patients with primary biliary cirrhosis.
OBJECTIVE
Fatigue, which may have a significant impact on quality of life, is the most common reported symptom in primary biliary cirrhosis (PBC). Multiple instruments to quantify fatigue and quality of life in liver disease have been validated, but have not been broadly applied to U.S. PBC patients. This study examines the extent of fatigue and its effect on quality of life in U.S. PBC patients.


METHODS
Seventy patients with PBC were administered two validated questionnaires about quality of life (the Mayo version of the NIDDK-QA) and fatigue (the Fisk Fatigue Impact Score) and a proposed physical measure of fatigue in PBC (the grip strength test) on the day of routine physician visit. Nonparametric methods were employed.


RESULTS
The fatigue and quality of life domain scores (physical functioning, liver symptoms, health satisfaction, Karnofsky index) discriminated between patients with and without self-reported fatigue (p < 0.05), as opposed to the grip strength results. Fatigue and quality of life domains correlated strongly with each other (r between 0.33 and 0.74, p</= 0.006) and not with the grip strength results. Neither quality of life nor fatigue scores correlated with age.


CONCLUSIONS
The correlation between fatigue and quality of life scores suggests fatigue has an impact on quality of life in U.S. primary biliary cirrhosis patients. However, our fatigue scores suggest U.S. PBC patients have less fatigue than non-U.S. PBC patients. The grip strength is an insensitive measure of fatigue in U.S. PBC patients.
Stanca
Carmen M
CM
Department of Medicine, The Mount Sinai School of Medicine, 1425 Madison Avenue, Room 1126, New York, NY 10029, USA.
Bach
Nancy
N
Krause
Cynthia
C
Tandon
Nidhi
N
Freni
Maria A
MA
Gutierrez
Julio A
JA
Bodian
Carol
C
Lopez
Jose
J
Berk
Paul D
PD
Bodenheimer
Henry C
HC
Branch
Andrea D
AD
Odin
Joseph A
JA
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003071:Cognition / Q000502:physiology; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D005221:Fatigue / Q000145:classification* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D017567:Karnofsky Performance Status; D008105:Liver Cirrhosis, Biliary / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010549:Personal Satisfaction; D011537:Pruritus / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014481:United States