Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.1067
Peer-review started: September 12, 2016
First decision: October 20, 2016
Revised: November 16, 2016
Accepted: January 11, 2017
Article in press: January 11, 2017
Published online: February 14, 2017
To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases (IBD).
This was a cross-sectional study conducted at the First Department of Pediatrics of the University of Athens at the “Aghia Sophia” Children’s Hospital. Children diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC), who were followed as outpatients or during a hospitalization, participated, after informed consent was obtained from their legal representative. QOL was assessed by the IMPACT-III questionnaire. Demographic data and disease characteristics were also collected. Statistical analyses included parametric (Student’s t-test and Pearson’s r) and non-parametric (Mann-Whitney test, Fisher’s test and Spearman’s rho) procedures.
Ninety-nine patients (UC: 37, 73.0% females, CD: 62, 51.6% females), aged 12.8 ± 2.6 years were included. Overall, as well as, sub-domain scores did not differ between UC and CD (overall score: 73.9 ± 13.3 vs 77.5 ± 11.2, respectively, P = 0.16). In the entire sample, total score was related to physician’s global assessment (PGA, patients classified as “mild/moderate” active disease had, on average, 14.8 ± 2.7 points lower total scores compared to those “in remission”, P < 0.001) and age at IMPACT completion (Pearson’s r = 0.29, P = 0.05). Disease activity assessed by the indices Pediatric Ulcerative Colitis activity index, Pediatric Crohn’s disease activity index or PGA was significantly associated with all subdomains scores. Presence of extraintestinal manifestations had a negative impact on emotional and social functioning domains.
Disease activity is the main correlate of QOL in children with IBD, underlining the importance of achieving and sustaining clinical remission
Core tip: This study demonstrated that disease activity is the main correlate of quality of life (QOL) in children with inflammatory bowel diseases (IBD). Furthermore, several factors, that pose increased risks for impaired QOL for children with IBD, were identified. In brief, children of younger age, the early years after the diagnosis and the presence of extra-intestinal manifestations were inversely related to IMPACT-III scores. Therefore, in children with these specific features, physicians should be more vigilant in order to recognize and address issues related to their QOL promptly.