Fatigue measurements in patients with primary biliary cirrhosis and the risk of mortality during follow-up

Einar Björnsson, Evangelos Kalaitzakis, Matthias Neuhauser, Felicity Enders, Hardy Maetzel, Roger W. Chapman, Jayant Talwalkar, Keith Lindor, Roberta Jorgensen

Research output: Contribution to journalArticle

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Abstract

Background: Fatigue was recently suggested to predict an increased risk of mortality in a primary biliary cirrhosis (PBC) cohort during follow-up. Aims:: To analyse the impact of fatigue on prognosis in PBC. Methods:: Patients with PBC who had earlier completed the fatigue impact scale (FIS) were identified. Prognosis in terms of death and liver transplantation (Tx) was determined. Results:: FIS values at baseline were analysed from 208 patients (192 females; median age 59 years (interquartile range 51-67), median follow-up of 5 years. Overall, 181 patients were alive at follow-up, 22 (12%) died and five (2.4%) underwent transplantation. FIS at baseline was 28 (12-47) and FIS at follow-up was 25 (8-64) (P<0.001; r=0.69). Among survivors, FIS at baseline was 27 (12-43), 36 (12-72) in those who died (P=0.059) and 99 (41-102) in those who underwent transplantation (P=0.0008). FIS at baseline was 44 (12-88) in patients with death and/or Tx vs. 27 (12-43) in survivors (P=0.003). Age [hazard ratio (HR) 1.1 (confidence interval (CI) 1.0-1.2)] and aspartate aminotransferase [HR 2.0 (CI 1.3-3.0)] were independently associated with decreased survival on multivariate analysis. FIS scores over 40 [HR 9.6 (CI 2.3-39.7)] and bilirubin [HR 4.8 (CI 2.8-8.2)] were independently associated with a poor outcome in patients who underwent Tx or had a liver-related death. Conclusions:: Fatigue seems to change little over time in PBC. Fatigue levels were higher at baseline in those who died or underwent Tx. High fatigue levels seem to be a predictor of risk of liver-related mortality and need for transplantation over time but not a predictor of non-liver-related mortality.

Original languageEnglish (US)
Pages (from-to)251-258
Number of pages8
JournalLiver International
Volume30
Issue number2
DOIs
StatePublished - Feb 2010
Externally publishedYes

Fingerprint

Biliary Liver Cirrhosis
Fatigue
Mortality
Confidence Intervals
Transplantation
Survivors
Liver
Aspartate Aminotransferases
Bilirubin
Liver Transplantation
Multivariate Analysis

Keywords

  • Fatigue
  • Liver cirrhosis
  • Liver transplantation
  • Primary biliary cirrhosis
  • Prognosis

ASJC Scopus subject areas

  • Hepatology

Cite this

Björnsson, E., Kalaitzakis, E., Neuhauser, M., Enders, F., Maetzel, H., Chapman, R. W., ... Jorgensen, R. (2010). Fatigue measurements in patients with primary biliary cirrhosis and the risk of mortality during follow-up. Liver International, 30(2), 251-258. https://doi.org/10.1111/j.1478-3231.2009.02160.x

Fatigue measurements in patients with primary biliary cirrhosis and the risk of mortality during follow-up. / Björnsson, Einar; Kalaitzakis, Evangelos; Neuhauser, Matthias; Enders, Felicity; Maetzel, Hardy; Chapman, Roger W.; Talwalkar, Jayant; Lindor, Keith; Jorgensen, Roberta.

In: Liver International, Vol. 30, No. 2, 02.2010, p. 251-258.

Research output: Contribution to journalArticle

Björnsson, E, Kalaitzakis, E, Neuhauser, M, Enders, F, Maetzel, H, Chapman, RW, Talwalkar, J, Lindor, K & Jorgensen, R 2010, 'Fatigue measurements in patients with primary biliary cirrhosis and the risk of mortality during follow-up', Liver International, vol. 30, no. 2, pp. 251-258. https://doi.org/10.1111/j.1478-3231.2009.02160.x
Björnsson, Einar ; Kalaitzakis, Evangelos ; Neuhauser, Matthias ; Enders, Felicity ; Maetzel, Hardy ; Chapman, Roger W. ; Talwalkar, Jayant ; Lindor, Keith ; Jorgensen, Roberta. / Fatigue measurements in patients with primary biliary cirrhosis and the risk of mortality during follow-up. In: Liver International. 2010 ; Vol. 30, No. 2. pp. 251-258.
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abstract = "Background: Fatigue was recently suggested to predict an increased risk of mortality in a primary biliary cirrhosis (PBC) cohort during follow-up. Aims:: To analyse the impact of fatigue on prognosis in PBC. Methods:: Patients with PBC who had earlier completed the fatigue impact scale (FIS) were identified. Prognosis in terms of death and liver transplantation (Tx) was determined. Results:: FIS values at baseline were analysed from 208 patients (192 females; median age 59 years (interquartile range 51-67), median follow-up of 5 years. Overall, 181 patients were alive at follow-up, 22 (12{\%}) died and five (2.4{\%}) underwent transplantation. FIS at baseline was 28 (12-47) and FIS at follow-up was 25 (8-64) (P<0.001; r=0.69). Among survivors, FIS at baseline was 27 (12-43), 36 (12-72) in those who died (P=0.059) and 99 (41-102) in those who underwent transplantation (P=0.0008). FIS at baseline was 44 (12-88) in patients with death and/or Tx vs. 27 (12-43) in survivors (P=0.003). Age [hazard ratio (HR) 1.1 (confidence interval (CI) 1.0-1.2)] and aspartate aminotransferase [HR 2.0 (CI 1.3-3.0)] were independently associated with decreased survival on multivariate analysis. FIS scores over 40 [HR 9.6 (CI 2.3-39.7)] and bilirubin [HR 4.8 (CI 2.8-8.2)] were independently associated with a poor outcome in patients who underwent Tx or had a liver-related death. Conclusions:: Fatigue seems to change little over time in PBC. Fatigue levels were higher at baseline in those who died or underwent Tx. High fatigue levels seem to be a predictor of risk of liver-related mortality and need for transplantation over time but not a predictor of non-liver-related mortality.",
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AU - Björnsson, Einar

AU - Kalaitzakis, Evangelos

AU - Neuhauser, Matthias

AU - Enders, Felicity

AU - Maetzel, Hardy

AU - Chapman, Roger W.

AU - Talwalkar, Jayant

AU - Lindor, Keith

AU - Jorgensen, Roberta

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N2 - Background: Fatigue was recently suggested to predict an increased risk of mortality in a primary biliary cirrhosis (PBC) cohort during follow-up. Aims:: To analyse the impact of fatigue on prognosis in PBC. Methods:: Patients with PBC who had earlier completed the fatigue impact scale (FIS) were identified. Prognosis in terms of death and liver transplantation (Tx) was determined. Results:: FIS values at baseline were analysed from 208 patients (192 females; median age 59 years (interquartile range 51-67), median follow-up of 5 years. Overall, 181 patients were alive at follow-up, 22 (12%) died and five (2.4%) underwent transplantation. FIS at baseline was 28 (12-47) and FIS at follow-up was 25 (8-64) (P<0.001; r=0.69). Among survivors, FIS at baseline was 27 (12-43), 36 (12-72) in those who died (P=0.059) and 99 (41-102) in those who underwent transplantation (P=0.0008). FIS at baseline was 44 (12-88) in patients with death and/or Tx vs. 27 (12-43) in survivors (P=0.003). Age [hazard ratio (HR) 1.1 (confidence interval (CI) 1.0-1.2)] and aspartate aminotransferase [HR 2.0 (CI 1.3-3.0)] were independently associated with decreased survival on multivariate analysis. FIS scores over 40 [HR 9.6 (CI 2.3-39.7)] and bilirubin [HR 4.8 (CI 2.8-8.2)] were independently associated with a poor outcome in patients who underwent Tx or had a liver-related death. Conclusions:: Fatigue seems to change little over time in PBC. Fatigue levels were higher at baseline in those who died or underwent Tx. High fatigue levels seem to be a predictor of risk of liver-related mortality and need for transplantation over time but not a predictor of non-liver-related mortality.

AB - Background: Fatigue was recently suggested to predict an increased risk of mortality in a primary biliary cirrhosis (PBC) cohort during follow-up. Aims:: To analyse the impact of fatigue on prognosis in PBC. Methods:: Patients with PBC who had earlier completed the fatigue impact scale (FIS) were identified. Prognosis in terms of death and liver transplantation (Tx) was determined. Results:: FIS values at baseline were analysed from 208 patients (192 females; median age 59 years (interquartile range 51-67), median follow-up of 5 years. Overall, 181 patients were alive at follow-up, 22 (12%) died and five (2.4%) underwent transplantation. FIS at baseline was 28 (12-47) and FIS at follow-up was 25 (8-64) (P<0.001; r=0.69). Among survivors, FIS at baseline was 27 (12-43), 36 (12-72) in those who died (P=0.059) and 99 (41-102) in those who underwent transplantation (P=0.0008). FIS at baseline was 44 (12-88) in patients with death and/or Tx vs. 27 (12-43) in survivors (P=0.003). Age [hazard ratio (HR) 1.1 (confidence interval (CI) 1.0-1.2)] and aspartate aminotransferase [HR 2.0 (CI 1.3-3.0)] were independently associated with decreased survival on multivariate analysis. FIS scores over 40 [HR 9.6 (CI 2.3-39.7)] and bilirubin [HR 4.8 (CI 2.8-8.2)] were independently associated with a poor outcome in patients who underwent Tx or had a liver-related death. Conclusions:: Fatigue seems to change little over time in PBC. Fatigue levels were higher at baseline in those who died or underwent Tx. High fatigue levels seem to be a predictor of risk of liver-related mortality and need for transplantation over time but not a predictor of non-liver-related mortality.

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KW - Primary biliary cirrhosis

KW - Prognosis

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