Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities

Authors

Jorge D. Machicado, University of Pittsburgh
Stephen T. Amann, North Mississippi Medical Center
Michelle A. Anderson, University of Michigan
Judah Abberbock, University of Pittsburgh
Stuart Sherman, Indiana University
Darwin L. Conwell, Ohio State University
Gregory A. Cote, Medical University of South Carolina
Vikesh K. Singh, Johns Hopkins University
Michele D. Lewis, Mayo Clinic
Samer Alkaade, Saint Louis University
Bimaljit S. Sandhu, Richmond Gastroenterology Associates
Nalini M. Guda, Aurora Health Care
Thiruvengadam Muniraj, Yale University
Gong Tang, University of Pittsburgh
John Baillie, Virginia Commonwealth University
Randall E. Brand, University of Pittsburgh
Timothy B. Gardner, Dartmouth College
Andres Gelrud, University of Chicago
Christopher E. Forsmark, University of Florida
Peter A. Banks, Harvard University
Adam Slivka, University of Pittsburgh
C. Mel Wilcox, University of Alabama
David C. Whitcomb, University of Pittsburgh
Dhiraj Yadav, University of Pittsburgh

Document Type

Article

Original Publication Date

2017

Journal/Book/Conference Title

AMERICAN JOURNAL OF GASTROENTEROLOGY

Volume

112

Issue

4

First Page

633

Last Page

642

DOI of Original Publication

10.1038/ajg.2017.42

Comments

Originally published at http://doi.org/10.1038/ajg.2017.42

Date of Submission

June 2017

Abstract

OBJECTIVES: Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients.

METHODS: We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype, and treatments was obtained from responses to structured questionnaires. Physical and mental component summary (PCS and MCS, respectively) scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL.

RESULTS: Mean PCS and MCS scores were 36.7+/-11.7 and 42.4+/-12.2, respectively. Significant (P < 0.05) negative impact on PCS scores in multivariable analyses was noted owing to constant mild-moderate pain with episodes of severe pain or constant severe pain (10 points), constant mild-moderate pain (5.2), pain-related disability/unemployment (5.1), current smoking (2.9 points), and medical co-morbidities. Significant (P < 0.05) negative impact on MCS scores was related to constant pain irrespective of severity (6.8-6.9 points), current smoking (3.9 points), and pain-related disability/unemployment (2.4 points). In women, disability/unemployment resulted in an additional 3.7 point reduction in MCS score. Final multivariable models explained 27% and 18% of the variance in PCS and MCS scores, respectively. Etiology, disease duration, pancreatic morphology, diabetes, exocrine insufficiency, and prior endotherapy/pancreatic surgery had no significant independent effect on QOL.

CONCLUSIONS: Constant pain, pain-related disability/unemployment, current smoking, and concurrent co-morbidities significantly affect the QOL in CP. Further research is needed to identify factors impacting QOL not explained by our analyses.

Rights

© 2017 by the American College of Gastroenterology

Is Part Of

VCU Pathology Publications