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

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

Research output: Contribution to journalArticle

17 Citations (Scopus)

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

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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

Fatigue measurements in patients with primary biliary cirrhosis and the risk of mortality during follow-up. / Björnsson, Einar; Kalaitzakis, Evangelos; Neuhauser, Matthias; Enders, Felicity T; 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, FT, 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 T ; 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 T

AU - Maetzel, Hardy

AU - Chapman, Roger W.

AU - Talwalkar, Jayant

AU - Lindor, Keith

AU - Jorgensen, Roberta

PY - 2010/2

Y1 - 2010/2

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 - Liver cirrhosis

KW - Liver transplantation

KW - Primary biliary cirrhosis

KW - Prognosis

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