Quality of life: a potentially useful measure to indicate subclinical flares in Crohn disease


  • Funding: This work was supported by grant 33CSCO-108792 from the Swiss National Science Foundation to Roland von Känel & Stefan Begré (Mental Health Core Project of the Swiss Inflammatory Bowel Disease Cohort Study). The funding source was not involved in data collection, analysis, interpretation or writing.

  • Conflict of interest: None.

Roland von Känel, Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, Freiburgstrasse, CH-3010 Bern, Switzerland. Email: roland.vonkaenel@insel.ch


Background:  While quality of life (QoL) is a well-recognised outcome measure of Crohn disease (CD) activity, its influence on other outcome measures, including exacerbation of CD is poorly understood. If QoL measures were to be associated with intestinal inflammatory activity, they might be useful for early detection of subclinical flares.

Aims:  We hypothesised that low QoL might be associated with subsequent CD flares.

Methods:  A cohort of 318 adult CD patients was observed for 1 year after assessment of baseline characteristics. Data were collected in Swiss university hospitals, regional hospitals and private practices. At inclusion, patients completed the Inflammatory Bowel Disease QoL Questionnaire (gastrointestinal QoL; range: 32 to 224 points) and the Short Form-36 Health Survey (general QoL; range: 35 to 145 points). During follow up, flares were recorded. Binary logistic regression was performed to estimate the relation between QoL and the odds of subsequent flares.

Results:  A twofold decrease in the odds of flares (99% CI: 1.1; 4.0) per standard deviation of gastrointestinal QoL and a threefold decrease (99% CI: 1.5; 6.2) per standard deviation of general QoL were observed.

Conclusions:  The close association between QoL and subsequent flares suggests that QoL measures might be useful in detecting upcoming flares before they become clinically apparent.