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Multicenter Study
. 2019 Jan-Dec:13:1753466619878128.
doi: 10.1177/1753466619878128.

Fatigue is highly prevalent in patients with COPD and correlates poorly with the degree of airflow limitation

Yvonne M J Goërtz  1 , Martijn A Spruit  2   3   4   5 , Alex J Van 't Hul  6 , Jeannette B Peters  6   7 , Maarten Van Herck  3 , Nienke Nakken  8 , Remco S Djamin  9 , Chris Burtin  3 , Melissa S Y Thong  10 , Arnold Coors  11 , Yvonne Meertens-Kerris  12 , Emiel F M Wouters  8   4 , Judith B Prins  7 , Frits M E Franssen  8   4   5 , Jean W M Muris  13 , Lowie E G W Vanfleteren  8   4   14 , Mirjam A G Sprangers  10 , Daisy J A Janssen  8   15 , Jan H Vercoulen  6   7
Affiliations
Multicenter Study

Fatigue is highly prevalent in patients with COPD and correlates poorly with the degree of airflow limitation

Yvonne M J Goërtz et al. Ther Adv Respir Dis. 2019 Jan-Dec.

Abstract

Background: The objective of this study was to compare fatigue levels between subjects with and without COPD, and to investigate the relationship between fatigue, demographics, clinical features and disease severity.

Methods: A total of 1290 patients with COPD [age 65 ± 9 years, 61% male, forced expiratory volume in 1 s (FEV1) 56 ± 19% predicted] and 199 subjects without COPD (age 63 ± 9 years, 51% male, FEV1 112 ± 21% predicted) were assessed for fatigue (Checklist Individual Strength-Fatigue), demographics, clinical features and disease severity.

Results: Patients with COPD had a higher mean fatigue score, and a higher proportion of severe fatigue (CIS-Fatigue score 35 ± 12 versus 21 ± 11 points, p < 0.001; 49 versus 10%, p < 0.001). Fatigue was significantly, but poorly, associated with the degree of airflow limitation [FEV1 (% predicted) Spearman correlation coefficient = -0.08, p = 0.006]. Multiple regression indicated that 30% of the variance in fatigue was explained by the predictor variables.

Conclusions: Severe fatigue is prevalent in half of the patients with COPD, and correlates poorly with the degree of airflow limitation. Future studies are needed to better understand the physical, psychological, behavioural, and systemic factors that precipitate or perpetuate fatigue in COPD.

Keywords: airway obstruction; chronic obstructive pulmonary disease; fatigue.

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Conflict of interest statement

Conflict of interest statement: AstraZeneca, the Netherlands; Boehringer Ingelheim, the Netherlands

Figures

Figure 1.
Figure 1.
Prevalence of normal, mild and severe fatigue in persons with and without COPD. COPD, chronic obstructive pulmonary disease.
Figure 2.
Figure 2.
(a) Fatigue scores (mean and 95% CI) after stratification for the degree of dyspnoea: grade 0–4 on the mMRC dyspnoea scale. (b) Fatigue scores (mean and 95% CI) after stratification for the BMI classification (underweight BMI < 20 kg/m2, normal weight BMI 20–25 kg/m2, overweight BMI 25–30 kg/m2, obese BMI > 30 kg/m2). BMI, body mass index; CI, confidence interval; mMRC, modified Medical Research Council.
Figure 3.
Figure 3.
Scatterplot showing the poor association between fatigue and FEV1 (% predicted). FEV1, forced expiratory volume over 1 s of predicted.
Figure 4.
Figure 4.
Scatterplot showing the strong association between fatigue and the CAT. CAT, COPD assessment test
See this image and copyright information in PMC

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