Quality of life in children with Crohn disease.
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.
Hill
Rj
R
University of Queensland, Children's Nutrition Research Centre, Discipline of Paediatrics and Child Health, Australia. rj.hill@uq.edu.au
Lewindon
Pj
P
Muir
R
R
Grangé
I
I
Connor
Fl
F
Ee
Lc
L
Withers
Gd
G
Cleghorn
Gj
G
Davies
Psw
P
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