Assessment of fatigue and functional impairment in patients with rheumatic diseases

Abstract

Aim of the workTo assess fatigue and functional impairment in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS) and fibromyalgia (FM) patients and their correlation with the corresponding clinical characteristics and determine their predictors. Patients and methods150 patients (40 RA, 40 SLE, 40 primary FM and 30 AS) and 80 matched controls were studied. All patients underwent full clinical examination and laboratory investigations to score disease activity and severity. Fatigue was assessed by the short form-36 (SF-36) and the visual analogue scale (VAS) of fatigue. Functional status was assessed by the modified health assessment questionnaire (mHAQ). ResultsThe patients were 112 females and 38 males and the mean age was 36.7 ± 12.2 years. Fatigue and functional impairment were significantly higher in all patients compared to control. The highest frequency of fatigue was found in FM (100%) and the lowest in AS (60%). Functional impairment was 100% in FM and lowest in SLE (27.5%). Fatigue and functional impairment were more severe in RA and SLE females and in AS males. Fatigue and functional impairment significantly correlated with disease activity and severity for all the studied diseases. On regression, disease activity and severity in RA and SLE as well as severity in FM and activity in AS were predictors of fatigue and functional impairment. ConclusionsFatigue and functional impairment are common in rheumatic diseases and strongly related to disease activity and severity. Good control of fatigue and functional impairment can be achieved through early control of disease activity and severity.