Fatigue: a principal contributor to impaired quality of life in ANCA-associated vasculitis

Rheumatology (Oxford). 2010 Jul;49(7):1383-90. doi: 10.1093/rheumatology/keq098. Epub 2010 Apr 17.


Objectives: To describe quality of life (QoL) in an ANCA-associated vasculitis (AAV) cohort and make comparisons with a general population sample. In addition, we aimed to take preliminary steps to identify potential disease and psycho-social factors which may determine QoL impairment.

Methods: A population-based case-control study was designed. All AAV patients resident in Grampian, Scotland, were invited to participate as cases. Controls were identified from a random sample of persons registered with four local general practices. Participants completed a questionnaire comprising validated generic and symptom-specific tools in the assessment of QoL. In addition, all cases were clinically assessed and putative disease factors recorded. Cases and controls were compared and, in addition, disease and psycho-social associations were explored for identified QoL impairments.

Results: In total, 74/90 (82%) cases and 781/2000 (39%) controls participated. Cases reported a significant impairment in physical health (P < 0.0001), but not mental health (P = 0.85), compared with controls, as measured by Short Form-8 (SF-8). Following adjustment for age and sex, persons with AAV were more than twice as likely to report mild/moderate fatigue [odds ratio (OR) 2.0; 95% CI 1.1, 3.8] or severe fatigue (OR 2.5; 95% CI 1.4, 4.5) compared with controls. Furthermore, among cases, fatigue was found to be strongly associated with impaired physical health (P < 0.0001), while disease factors such as disease activity and damage were not (P = 0.60 and 0.27, respectively).

Conclusions: Patients with AAV report impaired physical but not mental health. Specifically, fatigue is a principal complaint and appears to be a major determinant of impaired QoL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / complications*
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / physiopathology
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / psychology
  • Fatigue / etiology*
  • Fatigue / physiopathology
  • Fatigue / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Scotland
  • Severity of Illness Index*
  • Statistics as Topic
  • Surveys and Questionnaires