title: Impact of fatigue in patients with chronic obstructive pulmonary disease: results from an exploratory study.
abstract: BACKGROUND
  Fatigue, which is also present in the healthy population, is a common but understudied symptom in chronic obstructive pulmonary disease (COPD). We hypothesized that clinically significant fatigue is also frequent in COPD and can be associated with an increased disease burden.
  
  
  METHODS
  An exploratory analysis derived from an ongoing cross-sectional study was carried out to evaluate levels of fatigue and impact on health-related quality of life/health status in patients with COPD (COPD group; n = 20) and healthy subjects (control group; n = 5). Health-related quality of life was measured using the Short Form Health Survey 36 (SF-36), health status with the Clinical COPD Questionnaire (CCQ), and airways obstruction with postbronchodilator forced expiratory volume in 1 s (FEV1 %predicted). Fatigue was measured with the vitality score of the SF-36, its clinical significance being defined by values of 50 or less. Fatigue was also measured using the Functional Assessment of Chronic Illness Therapy scale for fatigue (FACIT-F).
  
  
  RESULTS
  Vitality scores were significantly worse in the COPD group (45.60 versus 76.25; p = 0.004). FACIT-F scores were significantly lower in the COPD group versus the control group (74.5 versus 95.0; p = 0.03). Clinically significant fatigue was detected in 60% of the COPD group, and was associated with a worse FEV1 %predicted (47.71 versus 65.82%; p = 0.016), worse symptoms burden (CCQ symptoms score 3.75 versus 2.43; p = 0.019), and worse overall health status (CCQ total score 3.30 versus 2.11; p = 0.011). Its link with systemic inflammation remains to be clarified further.
  
  
  CONCLUSIONS
  Clinically significant fatigue is common among patients with COPD and is associated with an increased disease burden. It should therefore be integrated as a measure of disease prognosis and control in patients with COPD.
authors.affiliation: Department of Preventive Medicine and Interdisciplinarity, Medicine-Palliative Care Nursing, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., Iasi, 700115, Romania sabina.antoniu@umfiasi.ro.
authors.forename: Sabina Antonela
authors.initials: SA
authors.lastname: Antoniu
authors.affiliation: Department of Morphofunctional Sciences, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Elena
authors.initials: E
authors.lastname: Petrescu
authors.affiliation: Department of Morphofunctional Sciences, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Raluca
authors.initials: R
authors.lastname: Stanescu
authors.affiliation: Laboratory of Immunology, Sf. Spiridon University Hospital, Iasi, Romania.
authors.forename: Ecaterina
authors.initials: E
authors.lastname: Anisie
authors.affiliation: Department of Preventive Medicine and Interdisciplinarity, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Lucian
authors.initials: L
authors.lastname: Boiculese
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D011788:Quality of Life; D012720:Severity of Illness Index
keywords: chronic obstructive pulmonary disease; fatigue; health status; health-related quality of life