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Clinical relevance of fatigue levels in cancer patients at a Veterans Administration Medical Center†
Article first published online: 25 APR 2002
Copyright © 2002 American Cancer Society
Volume 94, Issue 9, pages 2481–2489, 1 May 2002
How to Cite
Hwang, S. S., Chang, V. T., Cogswell, J. and Kasimis, B. S. (2002), Clinical relevance of fatigue levels in cancer patients at a Veterans Administration Medical Center. Cancer, 94: 2481–2489. doi: 10.1002/cncr.10507
The views expressed herein do not necessarily reflect the views of the Department of Veterans Affairs or the U.S. Government.
- Issue published online: 25 APR 2002
- Article first published online: 25 APR 2002
- Manuscript Accepted: 21 NOV 2001
- Manuscript Received: 21 SEP 2001
- functional interference;
- quality of life;
The correlation of fatigue levels with functional interference, symptom distress, and quality of life may help determine clinically significant fatigue levels.
One hundred eighty consecutive patients with cancer completed the Functional Assessment of Cancer Therapy (FACT) General and Fatigue subscales (FACT-G and FACT-F, respectively), the Memorial Symptom Assessment Scale-Short Form (MSAS-SF), the Depression Scale (Zung), and the Brief Fatigue Inventory (BFI). The Karnofsky performance status (KPS) was determined for each patient. Multivariate analyses of variance were performed to compare fatigue models with different cut-off points to categorize fatigue levels. Cox proportional hazards analysis was performed to assess the association between fatigue severity and survival.
Increased fatigue levels were associated with greater symptom distress and decreased quality of life. A model with usual fatigue cut-off points of 0 (no fatigue), 1–2 (mild fatigue), 3–6 (moderate fatigue), and 7–10 (severe fatigue) was optimal in relation to functional interference items (Wilks λ, 0.36; F = 11.61; P < 0.0001), symptom distress scores (Wilks λ, 0.52; F = 10.41; P < 0.0001), and quality-of-life scores (Wilks λ, 0.50; F = 0.50; P < 0.0001). Fatigue severity predicted survival in univariate analysis (chi-square test, 25.42; P < 0.0001). The KPS, stage of disease, and number of symptoms independently predicted survival in patients with fatigue.
Clinically relevant fatigue levels are correlated with symptom and quality-of-life measurements. Patients with a usual fatigue severity > 3 or a worst fatigue severity > 4 on a 1–10 scale may require further assessment. Cancer 2002;94:2481–9. © 2002 American Cancer Society.