Jorge D Machicado1, Stephen T Amann2, Michelle A Anderson3, Judah Abberbock1, Stuart Sherman4, Darwin L Conwell5, Gregory A Cote6, Vikesh K Singh7, Michele D Lewis8, Samer Alkaade9, Bimaljit S Sandhu10, Nalini M Guda11, Thiruvengadam Muniraj12, Gong Tang1, John Baillie13, Randall E Brand1, Timothy B Gardner14, Andres Gelrud15, Christopher E Forsmark16, Peter A Banks17, Adam Slivka1, C Mel Wilcox18, David C Whitcomb1, Dhiraj Yadav1. 1. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 2. North Mississippi Medical Center, Tupelo, Mississippi, USA. 3. University of Michigan, Ann Arbor, Michigan, USA. 4. Indiana University, Indianapolis, Indiana, USA. 5. Ohio State University, Columbus, Ohio, USA. 6. Medical University of South Carolina, Charleston, South Carolina, USA. 7. Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. 8. Mayo Clinic, Jacksonville, Florida, USA. 9. Saint Louis University, St Louis, Missouri, USA. 10. Richmond Gastroenterology Associates, Richmond, Virginia, USA. 11. Aurora Health Care, Milwaukee, Wisconsin, USA. 12. Yale School of Medicine, New Haven, Cincinnati, USA. 13. Virginia Commonwealth University, Richmond, Virginia, USA. 14. Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA. 15. University of Chicago, Chicago, Illinois, USA. 16. University of Florida, Gainesville, Florida, USA. 17. Brigham and Women's Hospital, Boston, Massachusetts, USA. 18. University of Alabama at Birmingham, Birmingham, Alabama, USA.
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.
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 CPpatients. METHODS: We used data on 1,024 CPpatients 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.
Authors: Joel Swendsen; Kevin P Conway; Louisa Degenhardt; Meyer Glantz; Robert Jin; Kathleen R Merikangas; Nancy Sampson; Ronald C Kessler Journal: Addiction Date: 2010-03-10 Impact factor: 6.526
Authors: Stephen Clayton; Clare Bambra; Rachael Gosling; Sue Povall; Kate Misso; Margaret Whitehead Journal: BMC Public Health Date: 2011-03-21 Impact factor: 3.295
Authors: Markus Wehler; Ralf Nichterlein; Bernhard Fischer; Michael Farnbacher; Udo Reulbach; Eckhart Georg Hahn; Thomas Schneider Journal: Am J Gastroenterol Date: 2004-01 Impact factor: 10.864
Authors: Tim Strate; Kai Bachmann; Philipp Busch; Oliver Mann; Claus Schneider; Jens P Bruhn; Emre Yekebas; Thomas Kuechler; Christian Bloechle; Jakob R Izbicki Journal: Gastroenterology Date: 2008-03-04 Impact factor: 22.682
Authors: Sarah J Schwarzenberg; Aliye Uc; Bridget Zimmerman; Michael Wilschanski; C Mel Wilcox; David C Whitcomb; Steven L Werlin; David Troendle; Gong Tang; Adam Slivka; Vikesh K Singh; Stuart Sherman; Uzma Shah; Bimaljit S Sandhu; Joseph Romagnuolo; Sue Rhee; John F Pohl; Emily R Perito; Chee Y Ooi; Jaimie D Nathan; Thiruvengadam Muniraj; Veronique D Morinville; Brian McFerron; Maria Mascarenhas; Asim Maqbool; Quin Liu; Tom K Lin; Michele Lewis; Sohail Z Husain; Ryan Himes; Melvin B Heyman; Nalini Guda; Tanja Gonska; Matthew J Giefer; Andres Gelrud; Cheryl E Gariepy; Timothy B Gardner; Steven D Freedman; Christopher E Forsmark; Douglas S Fishman; Gregory A Cote; Darwin Conwell; Randall E Brand; Melena Bellin; Bradley Barth; Peter A Banks; Michelle A Anderson; Stephen T Amann; Samer Alkaade; Maisam Abu-El-Haija; Judah N Abberbock; Mark E Lowe; Dhiraj Yadav Journal: J Pediatr Gastroenterol Nutr Date: 2019-04 Impact factor: 2.839
Authors: Celeste A Shelton; Robin E Grubs; Chandraprakash Umapathy; Dhiraj Yadav; David C Whitcomb Journal: J Genet Couns Date: 2020-02-05 Impact factor: 2.537
Authors: Chathura B B Ratnayake; Sivesh K Kamarajah; Benjamin P T Loveday; Manu Nayar; Kofi Oppong; Steve White; Jeremy J French; John A Windsor; Sanjay Pandanaboyana Journal: J Gastrointest Surg Date: 2020-07-23 Impact factor: 3.452
Authors: Amir Gougol; Jorge D Machicado; Bassem Matta; Pedram Paragomi; Ioannis Pothoulakis; Adam Slivka; David C Whitcomb; Dhiraj Yadav; Georgios I Papachristou Journal: Pancreas Date: 2019 Nov/Dec Impact factor: 3.327
Authors: Zachary M Sellers; Donna MacIsaac; Helen Yu; Melody Dehghan; Ke-You Zhang; Rachel Bensen; Jessie J Wong; Cindy Kin; K T Park Journal: Gastroenterology Date: 2018-04-13 Impact factor: 22.682