Prevalence and characteristics of moderate to severe fatigue: a multicenter study in cancer patients and survivors.
Prevalence and characteristics of moderate to severe fatigue: a multicenter study in cancer patients and survivors.
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DOI：
10.1002/cncr.28434
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发表时间：
2014-02-01
期刊：
影响因子：
6.2
通讯作者：
Cleeland, Charles S.
中科院分区：
文献类型：
--
作者：
Wang, Xin Shelley;Zhao, Fengmin;Fisch, Michael J.;O'Mara, Ann M.;Cella, David;Mendoza, Tito R.;Cleeland, Charles S.
关键词：
有效管理癌症患者的疲劳需要清楚地描述什么构成了非平凡的疲劳。我们定义了基于功能干扰的疲劳严重程度的数字临界点，并描述了癌症患者和幸存者的疲劳患病率和特征。在一项多中心研究中，患有乳腺癌、前列腺癌、结肠直肠癌或肺癌的门诊患者评定疲劳严重程度和症状对M功能的干扰。D.安德森症状量表（MDASI）0-10量表。MDASI的症状干扰评级指导选择轻度、中度和重度疲劳水平之间的数字评级分界点。回归分析确定了与报告中度/重度疲劳相关的重要因素。统计学最佳临界点为≥4（中度疲乏）和≥7（重度疲乏）。45%报告中度/重度疲劳（983/2177），更可能发生在服用强效阿片类药物的患者中（比值比[OR]，3.00），体能状态较差（OR，2.00），6个月内体重减轻>5%（OR，1.60），正在服用>10种药物（OR，1.58），患有肺癌（OR，1.55），或有抑郁症史（OR，1.42）。在幸存者（完全缓解或无疾病证据，且当前未接受癌症治疗的患者）中，29%（150/515）的患者存在中度/重度疲劳，与体能状态差（OR，3.48）和抑郁史（OR，2.21）相关。本研究统计定义了与显著增加的症状干扰相关的疲劳严重程度类别。积极治疗的癌症患者和幸存者中中度/重度疲劳的高患病率保证了对患者报告的疲劳的常规评估和管理的促进。
Effective management of fatigue in cancer patients requires a clear delineation of what constitutes nontrivial fatigue. We defined numeric cutpoints for fatigue severity based on functional interference and described fatigue’s prevalence and characteristics in cancer patients and survivors. In a multicenter study, outpatients with breast, prostate, colorectal, or lung cancer rated fatigue severity and symptom interference with functioning on the M. D. Anderson Symptom Inventory (MDASI) 0–10 scale. MDASI ratings of symptom interference guided selection of numeric rating cutpoints between mild, moderate, and severe fatigue levels. Regression analysis identified significant factors related to reporting moderate/severe fatigue. The statistically optimal cutpoints were ≥4 for moderate fatigue and ≥7 for severe fatigue. Moderate/severe fatigue was reported by 45% (983/2177) of patients undergoing active treatment and was more likely to occur in patients taking strong opioids (odds ratio [OR], 3.00), had poor performance status (OR, 2.00), had >5% weight loss within 6 months (OR, 1.60), were taking >10 medications (OR, 1.58), had lung cancer (OR, 1.55), or had a history of depression (OR, 1.42). Among survivors (patients with complete remission or no evidence of disease, and no current cancer treatment), 29% (150/515) had moderate/severe fatigue that was associated with poor performance status (OR, 3.48) and a history of depression (OR, 2.21). This study statistically defined fatigue-severity categories related to significantly increased symptom interference. The high prevalence of moderate/severe fatigue in both actively treated cancer patients and survivors warrants the promoting of routine assessment and management of patient-reported fatigue.
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影响因子：
4.7
作者：
Barsevick, Andrea M.;Cleeland, Charles S.;Manning, Donald C.;O'Mara, Ann M.;Reeve, Bryce B.;Scott, Jane A.;Sloan, Jeff A.
通讯作者：
Sloan, Jeff A.
影响因子：
7.4
作者：
Hirschfeld, Gerrit;Zernikow, Boris
通讯作者：
Zernikow, Boris
影响因子：
7.4
作者：
SERLIN, RC;MENDOZA, TR;CLEELAND, CS
通讯作者：
CLEELAND, CS
影响因子：
6.2
作者：
Jean-Pierre, Pascal;Morrow, Gary R.;Roscoe, Joseph A.;Heckler, Charles;Mohile, Supriya;Janelsins, Michelle;Peppone, Luke;Hemstad, Amy;Esparaz, Benjamin T.;Hopkins, Judith O.
通讯作者：
Hopkins, Judith O.
影响因子：
10.3
作者：
Wang, Xin Shelley;Cleeland, Charles S.;Johnson, Valen E.
通讯作者：
Johnson, Valen E.