title: Fatigue: a principal contributor to impaired quality of life in ANCA-associated vasculitis.
abstract: OBJECTIVE
  To describe quality of life (QoL) in an ANCA-associated vasculitis (AAV) cohort and make comparisons with a general population sample. In addition, we aimed to take preliminary steps to identify potential disease and psycho-social factors which may determine QoL impairment.
  
  
  METHODS
  A population-based case-control study was designed. All AAV patients resident in Grampian, Scotland, were invited to participate as cases. Controls were identified from a random sample of persons registered with four local general practices. Participants completed a questionnaire comprising validated generic and symptom-specific tools in the assessment of QoL. In addition, all cases were clinically assessed and putative disease factors recorded. Cases and controls were compared and, in addition, disease and psycho-social associations were explored for identified QoL impairments.
  
  
  RESULTS
  In total, 74/90 (82%) cases and 781/2000 (39%) controls participated. Cases reported a significant impairment in physical health (P < 0.0001), but not mental health (P = 0.85), compared with controls, as measured by Short Form-8 (SF-8). Following adjustment for age and sex, persons with AAV were more than twice as likely to report mild/moderate fatigue [odds ratio (OR) 2.0; 95% CI 1.1, 3.8] or severe fatigue (OR 2.5; 95% CI 1.4, 4.5) compared with controls. Furthermore, among cases, fatigue was found to be strongly associated with impaired physical health (P < 0.0001), while disease factors such as disease activity and damage were not (P = 0.60 and 0.27, respectively).
  
  
  CONCLUSIONS
  Patients with AAV report impaired physical but not mental health. Specifically, fatigue is a principal complaint and appears to be a major determinant of impaired QoL.
authors.affiliation: Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill B25 2ZD, UK. neilbasu@abdn.ac.uk
authors.forename: Neil
authors.initials: N
authors.lastname: Basu
authors.forename: Gareth T
authors.initials: GT
authors.lastname: Jones
authors.forename: Nick
authors.initials: N
authors.lastname: Fluck
authors.forename: Alan G
authors.initials: AG
authors.lastname: MacDonald
authors.forename: Dong
authors.initials: D
authors.lastname: Pang
authors.forename: Paula
authors.initials: P
authors.lastname: Dospinescu
authors.forename: David M
authors.initials: DM
authors.lastname: Reid
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Macfarlane
mesh_terms: D000328:Adult; D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D005221:Fatigue / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012606:Scotland; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
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