Dr. Baron is the director and Dr. Taillefer is the research coordinator of the Canadian Scleroderma Research Group
Sociodemographic, disease, and symptom correlates of fatigue in systemic sclerosis: Evidence from a sample of 659 Canadian Scleroderma Research Group Registry patients
Version of Record online: 29 JUN 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 7, pages 966–973, 15 July 2009
How to Cite
Thombs, B. D., Hudson, M., Bassel, M., Taillefer, S. S., Baron, M. and Canadian Scleroderma Research Ggroup (2009), Sociodemographic, disease, and symptom correlates of fatigue in systemic sclerosis: Evidence from a sample of 659 Canadian Scleroderma Research Group Registry patients. Arthritis & Rheumatism, 61: 966–973. doi: 10.1002/art.24614
- Issue online: 29 JUN 2009
- Version of Record online: 29 JUN 2009
- Manuscript Accepted: 23 MAR 2009
- Manuscript Received: 14 SEP 2008
- New Investigator awards from the Canadian Institutes of Health Research
- Établissement de Jeunes Chercheurs awards from the Fonds de la Recherche en Santé du Québec
- Canadian Institutes of Health Research
- Cure Scleroderma Foundation
- Scleroderma Society of Canada
- Ontario Arthritis Society
- Actelion Pharmaceuticals
- Pfizer Pharmaceuticals
To assess fatigue levels and demographic, socioeconomic, disease, and psychosocial correlates of fatigue in patients with systemic sclerosis (SSc).
We conducted a cross-sectional, multicenter study of 659 patients with SSc from the Canadian Scleroderma Research Group Registry. Fatigue was assessed during annual Registry visits with the Short Form 36 (SF-36) health survey vitality subscale. Patients completed measures of depressive symptoms and pain and underwent clinical histories and medical examinations. Kendall's tau was used to assess bivariate association of sociodemographic, medical, and psychosocial variables with fatigue. Multivariable associations of demographic (step 1), socioeconomic (step 2), global disease (step 3), specific disease and lifestyle (step 4), and psychosocial (step 5) factors with fatigue were assessed using hierarchical multiple linear regression.
The mean ± SD score of the patients on the SF-36 vitality subscale was 45.6 ± 10.8, substantially lower (indicating more fatigue) than the mean ± SD score for the Canadian general population (65.8 ± 18.0). In multivariate analysis, higher fatigue was significantly associated with the number of medical comorbidities (standardized β = −0.11, P = 0.004), breathing problems (standardized β = −0.23, P < 0.001), the number of gastrointestinal (GI) symptoms (standardized β = −0.27, P < 0.001), and current smoking (standardized β = −0.08, P = 0.018). As a group, specific symptom and lifestyle variables predicted the most incremental variance in fatigue (▵R2 = 21.6%, P < 0.001), despite being added to the model after demographic, socioeconomic, and global disease duration/severity indicators. Symptoms of depression (β = −0.42) and pain (β = −0.21) were also independently associated with fatigue (P < 0.001).
High levels of fatigue are common in patients with SSc and are independently associated with clinical variables, including number of comorbidities, breathing problems, GI symptoms, and smoking.