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abstract
BACKGROUND
The
effective management of fatigue in patients with cancer requires a
clear delineation of what constitutes nontrivial fatigue. The authors
defined numeric cutpoints for fatigue severity based on functional
interference and described the prevalence and characteristics of fatigue
in patients with cancer and survivors.
METHODS
In
a multicenter study, outpatients with breast, prostate, colorectal, or
lung cancer rated their fatigue severity and symptom interference with
functioning on the M. D. Anderson Symptom Inventory numeric scale of 0
to 10. Ratings of symptom interference guided the selection of numeric
rating cutpoints between mild, moderate, and severe fatigue levels.
Regression analysis identified significant factors related to reporting
moderate/severe fatigue.
RESULTS
The
statistically optimal cutpoints were ≥ 4 for moderate fatigue and ≥ 7
for severe fatigue. Moderate/severe fatigue was reported by 983 of 2177
patients (45%) undergoing active treatment and was more likely to occur
in patients receiving treatment with strong opioids (odds ratio [OR],
3.00), those with a poor Eastern Cooperative Oncology Group performance
status (OR, 2.00), those who had > 5% weight loss within 6 months
(OR, 1.60), those who were receiving > 10 medications (OR, 1.58),
those with lung cancer (OR, 1.55), and those with a history of
depression (OR, 1.42). Among survivors (patients with complete remission
or no evidence of disease, and not currently receiving cancer
treatment), 29% of patients (150 of 515 patients) had moderate/severe
fatigue that was associated with poor performance status (OR, 3.48) and a
history of depression (OR, 2.21).
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