Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis

被引：59

作者：

Cote, Gregory A. ^{[1
]}

Yadav, Dhiraj ^{[2
]}

Abberbock, Judah A. ^{[2
]}

Whitcomb, David C. ^{[2
]}

Sherman, Stuart ^{[3
]}

Sandhu, Bimaljit S. ^{[4
]}

Anderson, Michelle A. ^{[5
]}

Lewis, Michele D. ^{[6
]}

Alkaade, Samer ^{[7
]}

Singh, Vikesh K. ^{[8
]}

Baillie, John ^{[9
]}

Banks, Peter A. ^{[10
]}

Conwell, Darwin ^{[11
]}

Guda, Nalini M. ^{[12
]}

Muniraj, Thiruvengadam ^{[13
]}

Tang, Gong ^{[2
]}

Brand, Randall ^{[2
]}

Gelrud, Andres ^{[14
]}

Amann, Stephen T. ^{[15
]}

Forsmark, Christopher E. ^{[16
]}

Wilcox, C. Mel ^{[17
]}

Slivka, Adam ^{[2
]}

Gardner, Timothy B. ^{[18
]}

机构：

[1] Med Univ South Carolina, Charleston, SC 29425 USA

[2] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA

[3] Indiana Univ Sch Med, Indianapolis, IN 46202 USA

[4] Richmond Gastroenterol Associates, Richmond, VA USA

[5] Univ Michigan, Ann Arbor, MI 48109 USA

[6] Mayo Clin, Jacksonville, FL 32224 USA

[7] St Louis Univ, St Louis, MO 63103 USA

[8] Johns Hopkins Med Inst, Baltimore, MD 21205 USA

[9] Virginia Commonwealth Univ, Richmond, VA USA

[10] Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA

[11] Ohio State Univ, Columbus, OH 43210 USA

[12] Aurora St Lukes Med Ctr, Milwaukee, WI USA

[13] Yale Sch Med, New Haven, CT USA

[14] Univ Chicago, Chicago, IL 60637 USA

[15] Digest Hlth Specialists, Tupelo, MS USA

[16] Univ Florida, Gainesville, FL USA

[17] Univ Alabama Birmingham, Birmingham, AL USA

[18] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2018年 / 113卷 / 06期

关键词：

ACUTE NECROTIZING PANCREATITIS; UNITED-STATES; FOLLOW-UP; PATIENT; PAIN; DISEASES; CANCER; COHORT; COSTS; CARE;

D O I：

10.1038/s41395-018-0087-7

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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) -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.

引用

页码：906 / 912

页数：7

共 38 条

[1] Risk of Recurrent Pancreatitis and Progression to Chronic Pancreatitis After a First Episode of Acute Pancreatitis [J].