Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis
Year: 2018
Type: article
Abstract: OBJECTIVES: The impact of recurrent acute pancreatitis (RAP) on quality of life (QOL) is unknown. We hypothesized that RAP would reduce QOL even in the absence of chronic pancreatitis (CP). METHODS: Data were pooled from three prospective, cross-sectional studies conducted across 27 U.S. centers (the North American Pancreatitis Studies); these included subjects with chronic pancreatitis (n = 1086), RAP alone (n = 508), and non-disease controls (n = 1025). QOL was measured using the Short Form 12 (SF-12), generating a Physical Component Summary (PCS) and the Mental Component Summary score (MCS). Multivariable regression models were developed to measure the effect of RAP on QOL, the predictors of lower QOL in those with RAP, and the differential effect QOL predictors between CP and RAP. RESULTS: Compared to controls (51.0 ± 9.4), subjects with RAP (41.1 ± 11.4) and CP (37.2 ± 11.8) had lower PCS (p < 0.01). Subjects with CP had lower PCS compared to those with RAP (p < 0.01). Similarly, MCS was lower among RAP (44.6 ± 11.5) and CP (42.8 ± 12.2) subjects compared to controls (51.7 ± 9.1, p < 0.01). Subjects with CP had lower MCS compared to those with RAP (p < 0.01). After controlling for independent predictors of PCS, RAP was associated with lower PCS (estimate -8.46, p < 0.01) and MCS (estimate -6.45, p < 0.0001) compared to controls. The effect of endocrine insufficiency on PCS was differentially greater among RAP subjects (-1.28 for CP vs. -4.9 for RAP, p = 0.0184). CONCLUSIONS: Even in the absence of CP, subjects with RAP have lower physical and mental QOL. This underscores the importance of identifying interventions to attenuate RAP before the development of overt CP.
Authors: Gregory A. Coté, Dhiraj Yadav, Judah A. Abberbock, David C. Whitcomb, Stuart Sherman, Bimaljit S. Sandhu, Michelle A. Anderson, Michele D. Lewis, Samer Alkaade, Vikesh K. Singh, John Baillie, Peter A. Banks, Darwin Conwell, Nalini M. Guda, Thiruvengadam Muniraj, Gong Tang, Randall Brand, Andres Gelrud, Stephen T. Amann, Christopher E. Forsmark, Mel C. Wilcox, Adam Slivka, Timothy B. Gardner
Institutions: Brigham and Women's Hospital, Mayo Clinic, Johns Hopkins University, Medical University of South Carolina, Virginia Commonwealth University, University of Michigan, University of Florida, University of Chicago, University of Pittsburgh Medical Center, Indiana University School of Medicine, The Ohio State University, Mayo Clinic in Florida, Saint Louis University, Johns Hopkins Medicine, Aurora St. Luke's Medical Center, Yale University, University of Alabama at Birmingham, Dartmouth–Hitchcock Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G2351745370, G2434943017, The Ohio State University Chronic Pancreatitis Diabetes Pancreas Cancer (CPDPC) Clinical Center, University of Pittsburgh Clinical and Translational Science Institute, G424479090, G5162886386, G884570035, UPMC Clinical Center for the Study of Chronic Pancreatitis and Diabetes
OpenAlex ID: W2805320772