P113 Quality of life in paediatric Crohn’s disease: data from the Imagekids study
V. M. Navas-López*1, 2, J. Martín-de-Carpi3, A. Grant4, T. D. Walters5, F. Ruemmele6, D. Mack7, M. Sladek8, R. Shamir9, R. Shaoul10, S. Saeed11, R. K. Russell12, R. Cytter-Kuint13, A. Griffiths14, D. Turner13, A. Otley4
1Paediatric Gastroenterology and Nutrition Unit, Hospital Materno Infantil, Málaga, Spain, 2IBIMA, Biomedical Institute of Málaga, Málaga, Spain, 3Unit for the Comprehensive Care of Paediatric Inflammatory Bowel Disease, Department of Paediatric Gastroenterology, Hepatology and Nutrition, Barcelona, Spain, 4IWK Health Centre, Halifax, Nova Scotia, Canada, 5Hospital for Sick Children, Toronto, Ontario, Canada, 6Hôpital Necker-Enfants Malades, Paris, France, 7Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada, 8Jagiellonian University Medical College, Krakow, Poland, 9Schneider Children’s Medical Centre, Petach Tikvah, Israel, 10Rambam Health Care Campus, Haifa, Israel, 11Cincinnati Children’s Hospital Medical Centre, Cincinnati, Ohio,United States, 12Royal Hospital for Children, Glasgow, United Kingdom, 13Institute of Paediatric Gastroenterology, Shaare Zedek Medical Centre, The Hebrew University of Jerusalem, Jerusalem, Israel, 14Hospital for Sick Children, Toronto, Canada
The evaluation of health-related quality of life (HRQOL), using the validated disease-specific IMPACT-III questionnaire, has a key role in ascertaining the effect of disease on patients with Crohn’s disease (CD). We sought to describe HRQOL variations across a large prospective cohort of paediatric CD patients with varying disease experience.
We used the prospectively collected data from the ImageKids study (a multicentre, multinational study designed to develop the pMEDIC and PICMI scores for magnetic resonance enterography) on children diagnosed with CD. IMPACT-III (35-item self-administered scale) was used to assess HRQOL in this cohort.
Data from 180 patients were analysed, 94 males (52.2%) with a mean age of 14.2 ± 2.2y and a median of 27 month (IQR 0.05–4.2) of follow-up. According to wPCDAI, 29.0% of patients were in clinical remission, whereas 39%, 13%, and 19% had mild, moderate, and severe disease, respectively. IMPACT-III total score had a poor but significant correlation with degree of mucosal inflammation judged by the SES-CD (r = -0.285, p < 0.0001). Correlation was strong with clinical activity judged by wPCDAI (r = -0.550, p < 0.0001). Patients with higher disease activity had lower total IMPACT-III score, as did the 4 domains (wellbeing, emotional functioning, social functioning, and body image, Table I). Differences across wPCDAI groups were higher for wellbeing and lower for body-image domains (Figure 1).
Table I IMPACT III total and domain scores (mean [SD]) according to wPCDAI and SES-CD
Figure 1. Differences in IMPACT III total score across disease activity (wPCDAI and SES-CD) groups.
Patients with perianal disease had lower wellbeing (p = 0.026) and body image (p = 0.004) domain scores. Steroid treatment was associated more with lower emotional functioning score than enteral nutrition was (p = 0.028).
In this ImageKids cohort, HRQOL was lower in patients with higher disease activity and in those with perianal disease. An awareness of which domains within IMPACT may be differentially affected by various therapies or disease characteristics could help the clinician by focusing interventions (ie, psychological) to address these areas of concern.