TY - JOUR
T1 - Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis
AU - Coté, Gregory A.
AU - Yadav, Dhiraj
AU - Abberbock, Judah A.
AU - Whitcomb, David C.
AU - Sherman, Stuart
AU - Sandhu, Bimaljit S.
AU - Anderson, Michelle A.
AU - Lewis, Michele D.
AU - Alkaade, Samer
AU - Singh, Vikesh K.
AU - Baillie, John
AU - Banks, Peter A.
AU - Conwell, Darwin
AU - Guda, Nalini M.
AU - Muniraj, Thiruvengadam
AU - Tang, Gong
AU - Brand, Randall
AU - Gelrud, Andres
AU - Amann, Stephen T.
AU - Forsmark, Christopher E.
AU - Wilcox, C. Mel
AU - Slivka, Adam
AU - Gardner, Timothy B.
N1 - Funding Information:
The study was supported by R01DK061451 (DCW), R01 DK077906 (DY), and U01 DK108306-01 (DC, CEF, DCW, DY), and UL1 RR024153 and UL1TR000005 (PI-Steven E Reis, MD). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Guarantor of the article: Gregory Cote accepts full responsibility for the conduct of the study. He had access to the data and control of the decision to publish. Specific author contributions: Planning and execution of the study: GAC, DY, JAA, DCW, TBG. Patient recruitment/data collection: GAC, DY, DCW, SS, BSS, JAA, MDL, SA, VKS, JB, PAB, DC, NMG, TM, GT, RB, AG, STA, CEF, AS, TBG. Manuscript drafting: GAC, DY, JAA, TBG. Critical editing and final approval of the manuscript: DCW, SS, BSS, MAA, MDL, SA, VKS, JB, PAB, DC, NMG, TM, GT, RB, AG, STA, CEF, AS. All authors have approved the final draft. Financial support: The study was supported by R01DK061451 (DCW), R01 DK077906 (DY), and U01 DK108306-01 (DC, CEF, DCW, DY), and UL1 RR024153 and UL1TR000005 (PI—Steven E Reis, MD). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Potential competing interests: None.
Publisher Copyright:
© 2018 American College of Gastroenterology.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - 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.
AB - 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.
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U2 - 10.1038/s41395-018-0087-7
DO - 10.1038/s41395-018-0087-7
M3 - Article
C2 - 29867178
AN - SCOPUS:85048028779
SN - 0002-9270
VL - 113
SP - 906
EP - 912
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 6
ER -