Clinical characteristics and outcomes of fatigued patients in a university hospital based family practice, Korea

ABSTRACT

BACKGROUD Fatigue is one of the most common problems encountered in family practice but its diagnosis and management are neither standardized nor simphfied. This basehne study was conducted to find out the clinical characteristics, dinical courses, and outcomes of fatigued patients. METHODS: This study included 163 fatigued patients who visited a department of a university hospital based family practice due to fatigue as their primary or secondary complaint. We dassified fatigue which persisted for more than 6 months as acute fatigue, less than 6 months as acute fatigue. Retrospective review of medical record was used to collect all rehted dinical characteristics and telephone interview was done to follow the course and outcomes of fatigue. RESULTS: Of the total 163 fatigued patients, 105 patients(64.4%) were men. Fifty two patients(31.9 %) visited the dinic for complete health check up due to fatigue. The rate of response to telephone interview was 62.6%. Fifty five patients(33.7%) were acute fatigue, 75 patients(46.0%) chronic fatigue, and 33 patients (20.2%) unknown duration of fatigue. Accordirg to the causes of fatigue, 11.7% of patients corresponded to organic cause, 60.7% psychiatric cause, 27.6% unknown cause. Specified organic causes of fatigue, chronic hepatitis was the most common disease followed by alcohol liver disease, arthritis, anemia, viral syndrome and hyperthyroidism As psychiatric causes af fatigue, stress was the most common cause followed by overwork, alcohol abuse, depression, and anxiety. Reassurance and observation(71.8%), drug tberapy(17.8%) were the mast common treatments. Those who felt their function decreased below 50% were 7.6% of total 102 patients. On the survival analysis, 58.2% of acute fatigue patients, 62.4% of chronic fatigue patients, 67.0% of unknown patients had fatigue for 2 years since the initial visit. CONCLUSIONS: As the cause af fatigue in a family practice, psychiatric causes were more frequent than organic causes. As psychiatric causes of fatigue, stress was the most common cause followed by overwork and alcohol abuse. Only one third of the fatigued patients had improved two years later.