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. 2016 Oct;10(5):410-24.
doi: 10.1177/1753465816661930. Epub 2016 Sep 1.

Factors associated with experience of fatigue, and functional limitations due to fatigue in patients with stable COPD

Magnus Kentson  1 , Kristina Tödt  2 , Elisabeth Skargren  3 , Per Jakobsson  4 , Jan Ernerudh  5 , Mitra Unosson  6 , Kersti Theander  7
Affiliations

Factors associated with experience of fatigue, and functional limitations due to fatigue in patients with stable COPD

Magnus Kentson et al. Ther Adv Respir Dis. 2016 Oct.

Abstract

Background: The aim of this study was to determine the influence of selected physiological, psychological and situational factors on experience of fatigue, and functional limitations due to fatigue in patients with stable chronic obstructive pulmonary disease (COPD).

Methods: In total 101 patients with COPD and 34 control patients were assessed for experience of fatigue, functional limitation due to fatigue (Fatigue Impact Scale), physiological [lung function, 6-minute walk distance (6MWD), body mass index (BMI), dyspnoea, interleukin (IL)-6, IL-8, high sensitivity C-reactive protein (hs-CRP), surfactant protein D], psychological (anxiety, depression, insomnia), situational variables (age, sex, smoking, living alone, education), and quality of life.

Results: Fatigue was more common in patients with COPD than in control patients (72% versus 56%, p < 0.001). Patients with COPD and fatigue had lower lung function, shorter 6MWD, more dyspnoea, anxiety and depressive symptoms, and worse health status compared with patients without fatigue (all p < 0.01). No differences were found for markers of systemic inflammation. In logistic regression, experience of fatigue was associated with depression [odds ratio (OR) 1.69, 95% confidence interval (CI) 1.28-2.25) and insomnia (OR 1.75, 95% CI 1.19-2.54). In linear regression models, depression, surfactant protein D and dyspnoea explained 35% (R(2)) of the variation in physical impact of fatigue. Current smoking and depression explained 33% (R(2)) of the cognitive impact of fatigue. Depression and surfactant protein D explained 48% (R(2)) of the psychosocial impact of fatigue.

Conclusions: Experiences of fatigue and functional limitation due to fatigue seem to be related mainly to psychological but also to physiological influencing factors, with depressive symptoms, insomnia problems and dyspnoea as the most prominent factors. Systemic inflammation was not associated with perception of fatigue but surfactant protein D was connected to some dimensions of the impact of fatigue.

Keywords: chronic obstructive pulmonary disease; fatigue; symptoms; systemic inflammation.

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Conflict of interest statement

Conflict of interest statement: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of recruitment and inclusion of patients with COPD and a control group selected from the general population. COPD, chronic obstructive airways disease; FEV1 forced expiratory volume in 1 second; FVC, forced vital capacity.
See this image and copyright information in PMC

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