PREVALENCE OF FATIGUE AND CHRONIC FATIGUE SYNDROME IN A PRIMARY-CARE PRACTICE
PREVALENCE OF FATIGUE AND CHRONIC FATIGUE SYNDROME IN A PRIMARY-CARE PRACTICE
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DOI：
10.1001/archinte.153.24.2759
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发表时间：
1993-12-27
影响因子：
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通讯作者：
KOMAROFF, AL
中科院分区：
文献类型：
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作者：
BATES, DW;SCHMITT, W;KOMAROFF, AL
背景资料：我们的目标是确定不寻常的，使人衰弱的疲劳和频率的患病率与慢性疲劳综合征（CFS）或其他身体或心理疾病在门诊population.Methods：我们前瞻性地评估了一个队列的1000例连续患者在一个城市的初级保健诊所，医院为基础的全科医学实践。研究方案包括详细的病史，体格检查，实验室和精神测试。结果：五名患者谁来，因为CFS研究被排除在外。在剩下的995人中，323人报告疲劳，271人（27%）抱怨至少6个月的异常疲劳干扰了他们的日常生活。在这271人中，自我报告或记录审查显示，186人（69%）的身体或精神状况可能解释了疲劳。因此，995例患者中有85例（8.5%）出现持续时间至少6个月的衰弱性疲乏，且无明显原因。在这些患者中，48例拒绝进一步评价，II无法进行随访; 26例完成了方案。26人中有3人甲状腺功能减退，1人有严重的精神障碍。在其余22名患者中，3名符合疾病控制和预防中心的CFS标准，4名符合英国标准，10名符合澳大利亚病例定义。因此，使用疾病控制和预防中心、英国和澳大利亚病例定义，CFS的点患病率分别为0.3%（95%置信区间ICI，0%至0.6%）、0.4%（95% CI，0%至0.8%）和1.0%（95% CI，0.4%至1.6%）。这些估计是保守的，因为他们假设没有拒绝评估或无法进行随访的患者将符合标准farCFS.Conclusions：虽然慢性，衰弱性疲劳是常见的医疗门诊患者，CFS是相对罕见的。患病率在很大程度上取决于所使用的病例定义。
Background: Our goals were to determine the prevalence of unusual, debilitating fatigue and the frequency with which it was associated with the chronic fatigue syndrome (CFS) or other physical or psychological illness in an outpatient clinic population.Methods: We prospectively evaluated a cohort of 1000 consecutive patients in a primary care clinic in an urban, hospital-based general medicine practice. The study protocol included a detailed history, physical examination, and laboratory and psychiatric testing.Results: Five patients who came because of CFS studies were excluded. Of the remaining 995, 323 reported fatigue, and 271 (27%) complained of at least 6 months of unusual fatigue that interfered with their daily lives. Of the 271, self-report or record review revealed a medical or psychiatric condition that could have explained the fatigue in 186 (69%). Thus, 85 (8.5%) of 995 patients had a debilitating fatigue of at least 6 months' duration, without apparent cause. Of these patients, 48 refused further evaluation, and II were unavailable for follow-up; 26 completed the protocol. Three of the 26 were hypothyroid, and one had a major psychiatric disorder. Of the remaining 22 patients, three met Centers for Disease Control and Prevention criteria for CFS, four met British criteria, and 10 met the Australian case definition. The point prevalences of CFS were thus 0.3% (95% confidence interval ICI], O% to 0.6%), 0.4% (95% CI, O% to 0.8%), and 1.0% (95% CI, 0.4% to 1.6%) using the Centers for Disease Control and Prevention, British, and Australian case definitions, respectively. These estimates were conservative, because they assumed that none of the patients who refused evaluation or were unavailable for follow-up would meet criteria far CFS.Conclusions: While chronic, debilitating fatigue is common in medical outpatients, CFS is relatively uncommon. Prevalence depends substantially on the case definition used.