To determine the correlation of factors associated with fatigue in advanced cancer patients and its impact on their quality of life
A prospective, observational study was conducted in the outpatient clinic of Department of Palliative Medicine from January to June 2014. Registered adult advanced cancer patients with PC clinic meeting the inclusion criteria ( ECOG = 3, ESAS fatigue score >/ = 1) were assessed after taking informed consent for symptom burden (ESAS) and QOL (EORTC-QOL PAL15) along with demographic details. They were given standard treatment for those symptoms. They met the PC team or were telephonically contacted for the same domains after an interval of 15-30days. Descriptive statistics, comparison of baseline and follow up data, correlation and multiple linear regressions between fatigue and symptoms at baseline, logistic regression model to determine factors associated with improvement in fatigue were performed.
A total of 402 subjects were assessed at baseline and follow-up (median age, 52 years; 51.6% male). Significant change in fatigue score was observed (p < 0.001) at follow-up. Hemoglobin, albumin levels, type of cancer, sites of metastasis, ECOG score, body weight, ESAS items except drowsiness, overall QOL, emotional functioning and constipation were found to be significantly associated with fatigue at baseline (p < 0.05). The logistic regression model showed that changes in hemoglobin and albumin levels, pain, dyspnea, physical functioning, insomnia on QOL scale significantly contributes to the improvement in fatigue.
Fatigue is strongly associated with certain physical, emotional and biochemical parameters; some of which are predictive of improvement of fatigue. As it is a single centered referral based study, its generalisability needs to be ascertained in a larger study.
Clinical trial identification
All authors have declared no conflicts of interest.