Relevance of the Phenotypic Characteristics of Crohn's Disease in Patient Perception of Health-Related Quality of Life

TLDR

Crohn’s disease negatively impacts patients’ health perception, with disease activity known to impair health‑related quality of life, yet the influence of phenotypic characteristics defined by the Vienna classification remains unclear. This study aimed to determine whether phenotypic CD characteristics per the Vienna classification affect health‑related quality of life. Health‑related quality of life was assessed in 198 Crohn’s disease patients using the Spanish IBDQ‑36, PGWBI, and EuroQol questionnaires. Multivariate analysis revealed that female sex, higher relapse frequency, and greater clinical disease activity were independently associated with poorer HRQoL, while none of the Vienna phenotypic variables showed a significant effect, indicating HRQoL impairment is independent of those clinical variables.

Abstract

BACKGROUND Crohn's disease (CD) has a negative impact on patients' perception of health. Several factors, such as disease activity, influence HRQOL impairment. However, the effect of the phenotypic CD characteristics recognized in the Vienna classification on health-related quality of life (HRQoL) remains unknown. METHODS HRQOL was measured in CD patients using three questionnaires: the Spanish version of the Inflammatory Bowel Disease Questionnaire (IBDQ-36), the Psychological General Well-Being Index (PGWBI), and the EuroQol. RESULTS One hundred ninety-eight CD patients were included. Scores for the IBDQ-36, PGWBI, and EuroQol dimensions did not differ according to age at diagnosis (177 patients under 40 yr and 21 over 40 yr), disease location (53 in terminal ileum, 62 in colon, 72 in ileocolon, and 11 in upper gastrointestinal tract) or disease behavior (99 nonstricturing-nonpenetrating, 32 stricturing, and 67 penetrating). Multivariate analysis identified as significant independent variables for worse HRQoL: female sex (t: −3.70), higher number of relapses per year (t: −2.71), and worse clinical disease activity (t: −7.82). None of the three Vienna variables reached statistical significance. CONCLUSIONS HRQoL impairment in CD patients is independent of the clinical variables established in the Vienna classification for phenotypic type of disease.