title: Quality of life in children with Crohn disease.
abstract: OBJECTIVE
  : Quality of life (QOL) is reportedly poor in children with Crohn disease (CD) but improves with increasing disease duration. This article aims to detail QOL in a cohort of Australian children with CD in relation to disease duration, disease activity, and treatment.
  
  
  METHODS
  : QOL, assessed using the IMPACT-III questionnaire, and disease activity measures, assessed using the Pediatric Crohn's Disease Activity Index (PCDAI), were available in 41 children with CD. For this cohort, a total of 186 measurements of both parameters were available.
  
  
  RESULTS
  : QOL was found to be significantly lower, and disease activity significantly higher (F = 31.1, P = 0.00), in patients within 6 months of their diagnosis compared with those up to 2.5 years, up to 5 years, and beyond 5 years since diagnosis. Higher disease activity was associated with poorer QOL (r = -0.51, P = 0.00). Total QOL was highest in children on nil medications and lowest in children on enteral nutrition. The PCDAI (t = -6.0, P = 0.00) was a significant predictor of QOL, with the clinical history (t = -6.9, P = 0.00) and examination (t = -2.9, P = 0.01) sections of the PCDAI significantly predicting QOL. Disease duration, age, or sex was neither related to nor significant predictors of QOL, but height z score and type of treatment approached significance.
  
  
  CONCLUSIONS
  : Children with CD within 6 months of their diagnosis have impaired QOL compared with those diagnosed beyond 6 months. These patients, along with those with growth impairment, ongoing elevated disease activity with abdominal pain, diarrhoea and/or perirectal and extraintestinal complications, may benefit from regular assessments of QOL as part of their clinical treatment.
authors.affiliation: University of Queensland, Children's Nutrition Research Centre, Discipline of Paediatrics and Child Health, Australia. rj.hill@uq.edu.au
authors.forename: Rj
authors.initials: R
authors.lastname: Hill
authors.forename: Pj
authors.initials: P
authors.lastname: Lewindon
authors.forename: R
authors.initials: R
authors.lastname: Muir
authors.forename: I
authors.initials: I
authors.lastname: Grangé
authors.forename: Fl
authors.initials: F
authors.lastname: Connor
authors.forename: Lc
authors.initials: L
authors.lastname: Ee
authors.forename: Gd
authors.initials: G
authors.lastname: Withers
authors.forename: Gj
authors.initials: G
authors.lastname: Cleghorn
authors.forename: Psw
authors.initials: P
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D001315:Australia; D001827:Body Height; D002648:Child; D015331:Cohort Studies; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy; D004750:Enteral Nutrition; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors