Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2017; 23(6): 1067-1075
Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.1067
Disease impact on the quality of life of children with inflammatory bowel disease
Giorgos Chouliaras, Daphne Margoni, Konstantina Dimakou, Smaragdi Fessatou, Ioanna Panayiotou, Eleftheria Roma-Giannikou
Giorgos Chouliaras, Daphne Margoni, Konstantina Dimakou, Smaragdi Fessatou, Ioanna Panayiotou, Eleftheria Roma-Giannikou, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
Author contributions: Chouliaras G and Margoni D contributed equally to this work; Roma-Giannikou E conceptualized and designed the study, supervised the analyses and wrote the manuscript; Chouliaras G is a medical biostatistician and performed the main statistical analysis; Chouliaras G and Margoni D designed the study, analysed the data and wrote the manuscript; Dimakou K, Fessatou S and Panayiotou I participated in study design, data collection and manuscript preparation; all authors approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of “Aghia Sophia” Children’s Hospital, Athens, Greece
Informed consent statement: All study participants, or their legal guardian, provided informed consent prior to study enrolment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No other data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giorgos Chouliaras, MD, PhD, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Thivon and Papadiamantopoulou street, 11527 Athens, Greece. georgehouliaras@msn.com
Telephone: +30-210-7467129 Fax: +30-21-32013237
Received: September 12, 2016
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
Processing time: 153 Days and 16.6 Hours
Abstract

AIM

To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases (IBD).

METHODS

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.

RESULTS

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.

CONCLUSION

Disease activity is the main correlate of QOL in children with IBD, underlining the importance of achieving and sustaining clinical remission

Keywords: Inflammatory bowel disease; ulcerative colitis; Crohn’s disease; quality of life; IMPACT-III; children

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.