P195 Prevalence and factors associated with fatigue in patients with inflammatory bowel disease

Abstract

Abstract Background Inflammatory bowel disease (IBD) is a group of pathologies characterized by symptoms that can be distressing and incapacitating. Fatigue is one of the complaints most frequently reported by patients. However, few studies have analyzed the determinants of fatigue in IBD. The aim of our work is to estimate the prevalence of fatigue, and to identify the factors associated with it in IBD patients. Methods Fatigue and nine other dimensions of IBD-related disability were assessed in a cross-sectional survey, including patients followed and hospitalized between March and September 2023, using the IBD-Disk questionnaire. Fatigue and severe fatigue were defined by an "Energy" sub-score > 5 and > 7 respectively. The correlation between Energy and the other IBD-Disk items was analyzed using Pearson's correlation coefficient. Determinants of fatigue were assessed using the Chi-2 test and multinomial logistic regression. Results We included 166 patients, 53.6% were men, and 69.3% were Crohn's disease carriers. Mean age was 39 ± 12.7 years. More than two-thirds (69.9%) lived in urban areas. IBD was active in 48.8% of cases. A total of 59% of patients were on biotherapy for maintenance treatment. The mean IBD-Disk total score was 36.4 ± 21. The Energy subscore obtained the highest score (4.9 ± 2.9). The prevalence rates for fatigue and severe fatigue were 42.2% and 22.9% respectively. Significant correlations were observed between fatigue and all other dimensions of IBD-related disability assessed by the IBD-Disk (p<0.001). The strongest correlations were observed between fatigue and defecation regulation (r=0.642), fatigue and work and study (r=0.630), and between fatigue and sleep (r=0.620) (Table 1). In univariate analysis, factors significantly associated with fatigue and severe fatigue were female gender (p=0.040 and 0.047 respectively), disease activity and hospitalization (p<0, 001 each), anemia (p=0.005 and 0.014 respectively), elevated CRP (p<0.001 and 0.030 respectively), hypoalbuminemia (p<0.001 and 0.042 respectively) and absence of biotherapy treatment (p=0.02 and 0.01 respectively). Living in an urban area was also associated with fatigue (p=0.015). In multivariate analysis, the independent risk factors predictive of fatigue were female gender, urban origin, hospitalization at the time of interview, and clinical disease activity. Independent risk factors for severe fatigue in multivariate analysis were female gender and clinical disease activity (Table 2). Conclusion The causes of fatigue are multiple and go beyond the clinico-biological elements associated with IBD, also encompassing social, geographical and sleep disturbance aspects. This underlines the need for a holistic approach to the management of IBD patients.