title: Risk factors for persistent fatigue with significant school absence in children and adolescents.
abstract: OBJECTIVE
  To assess children and adolescents with severe fatigue who are referred to pediatricians and to examine whether factors can be identified at their first visit that predict worse outcomes at 1 year.
  
  
  METHODS
  Ninety-one patients, aged 8 to 18 years completed questionnaires about sleep, somatic symptoms, physical activity, and fatigue. They were reassessed 12 months later. Measurements at baseline and outcome were analyzed by using univariable logistic regression with persistent, severe fatigue (yes/no) and persistent school absence (yes/no) as dependent variables and baseline scores as independent variables.
  
  
  RESULTS
  After 12 months, 50.6% of the children and adolescents showed improvement; 29.1% had persistent fatigue, and 20.3% had persistent fatigue with significant school absence. Factors associated with the poorest outcome were sleep problems (odds ratio [OR]: 1.4 [95% confidence interval (CI): 1.1-1.8]), initial fatigue score (OR: 1.1 [95% CI: 1.0-1.2]), somatic complaints such as hot and cold spells (OR: 1.9 [95% CI: 1.2-3.0]), blurred vision (OR: 2.1 [95% CI: 1.1-4.0]), pain in arms and legs (OR: 2.0 [95% CI: 1.0-3.2]), back pain (OR: 1.8 [95% CI: 1.0-3.2]), constipation (OR: 1.7 [95% CI: 1.0-2.7]), and memory deficits (OR: 1.8 [95% CI: 1.0-3.2]). Resolved fatigue was associated with male gender (OR: 5.0 [95% CI: 1.6-15.5]) and a physically active lifestyle (OR: 1.3 [95% CI: 1.1-1.5]).
  
  
  CONCLUSIONS
  Assessment of predictive factors at the first visit enables the pediatrician to identify those patients with severe fatigue who are at risk of a poor outcome. Female gender, poor sleep quality, physically inactive lifestyle, and specific somatic complaints were important predictive factors.
authors: Department of Pediatrics, Antonius Ziekenhuis, Sneek, Netherlands. robhelbz@telfort.nl
authors: Robert J
authors: RJ
authors: Bakker
authors: Elise M
authors: EM
authors: van de Putte
authors: Wietse
authors: W
authors: Kuis
authors: Gerben
authors: G
authors: Sinnema
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D002648:Child; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009043:Motor Activity; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires