P042 FATIGUE AND DISEASE ACTIVITY: A SECONDARY REVIEW OF PATIENT MEDICAL RECORDS

Introduction Fatigue is often the most prevalent symptom in inflammatory bowel disease (IBD). Previous research has highlighted that patients with active clinical disease activity have greater levels of fatigue compared to those with inactive clinical disease activity. Endoscopic assessment of inflammation is considered the best measure of disease activity; yet, clinical disease activity does not necessarily correlate with endoscopic inflammation. Therefore, there is a need to examine the relationship between endoscopic inflammation and fatigue. Methods A retrospective chart review was conducted of adult patients at an academic medical center. Participants were included in the review if they had a diagnosis of ulcerative colitis or Crohn’s disease, a clinic visit between 2018–2019 with completed Short Inflammatory Bowel Disease Questionnaire and clinical disease activity measures (Harvey Bradshaw Index [HBI] or Simple Clinical Colitis Activity Index [SCCAI]), and had a scored endoscopic disease activity score (Mayo Score of Ulcerative Colitis or the Simple Endoscopic Score for Crohn’s Disease) within 6 months of the clinic visit. Fatigue (range 1–7) was reversed scored; a higher number indicated increased fatigue. Descriptive statistics were calculated using STATA 14. Results Individuals (N=43) had a mean age of 37.4 (SD=12.3) and 54% were female. Disease location was 9% ileal, 53% ileocolonic, and 37% colonic; 54% were in endoscopic remission. The mean fatigue score was 4.2 (SD=1.7). There was no difference in fatigue between individuals in endoscopic remission (M=4.2, SD=1.6) compared to individuals with active endoscopic disease (M=4.2, SD=1.9; p=0.97). Fatigue was correlated with clinical disease activity measures including the HBI (r=0.61) and the SCCAI (r=0.58). Increased levels of fatigue were associated with abnormal c-reactive protein (p<0.01), erythrocyte sedimentation rate (p<0.01), and albumin (p=0.04) but not hematocrit (p=0.71) or hemoglobin (p=0.60). Conclusions The majority of the sample reported fatigue; however, fatigue did not correlate with endoscopic disease activity despite previous research suggesting that clinical disease activity correlates with fatigue. Further confounding our understanding of disease activity’s association with fatigue is the fact that clinical disease activity and biochemical abnormalities (CRP, ESR, albumin) did correlate with fatigue. Additional research is clearly needed to characterize the cause of fatigue among individuals with IBD.