Centre for Pancreatic Diseases, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Clinical Institute, Aalborg University, Aalborg, Denmark.
Gastrounit, Medical Section 360, Hvidovre University Hospital, Denmark.
Pancreatology. 2020 Oct;20(7):1347-1353. doi: 10.1016/j.pan.2020.09.004. Epub 2020 Sep 10.
Chronic pancreatitis (CP) is a debilitating fibro-inflammatory disease with a profound impact on patients' quality of life (QOL). We investigated determinants of QOL in a large cohort of CP patients.
This was a multicentre study including 517 patients with CP. All patients fulfilled the EORTC QLQ-C30 questionnaire. Questionnaire responses were compared to results obtained from a general reference population (n = 11,343). Demographic characteristics, risk factors (smoking and alcohol consumption), pain symptoms, disease phenotype (complications) and treatments were recorded. A multivariable regression model was used to identify factors independently associated with QOL scores.
Included patients had a mean age of 56.3 ± 12.8 years, 355 (69%) were men and 309 (60%) had alcohol aetiology. Compared to the reference population, patients with CP had lower global health status (50.5 vs. 66.1; p < 0.001) as well as reduced scores for all functional scales (all p < 0.001). Additionally, CP patients reported a higher burden for all symptom items, with pain being the most prominent complaint (all p < 0.001). Constant pain (coefficient -11.3; p = 0.02), opioid based pain treatment (coefficient -19.7; p < 0.001) and alcoholic aetiology (coefficient -5.1; p = 0.03) were independently associated with lowered global health status. The final multivariable model explained 18% of the variance in global health status.
Patients with CP have significantly lower QOL compared to a population-based reference population. Factors independently associated with a lowered QOL are constant pain, opioid based pain treatment and alcohol aetiology. However, these factors only explain a fraction of QOL and additional factors need identification.
慢性胰腺炎（CP）是一种使人虚弱的纤维炎症性疾病，对患者的生活质量（QOL）有深远影响。我们研究了大样本 CP 患者生活质量的决定因素。
这是一项包括 517 名 CP 患者的多中心研究。所有患者均完成 EORTC QLQ-C30 问卷。将问卷的回答与来自一般参考人群（n=11343）的结果进行比较。记录人口统计学特征、危险因素（吸烟和饮酒）、疼痛症状、疾病表型（并发症）和治疗方法。使用多变量回归模型确定与 QOL 评分独立相关的因素。
纳入的患者平均年龄为 56.3±12.8 岁，355 名（69%）为男性，309 名（60%）有酒精病因。与参考人群相比，CP 患者的总体健康状况评分较低（50.5 对 66.1；p<0.001），所有功能量表评分均降低（均 p<0.001）。此外，CP 患者报告所有症状项目的负担更高，其中疼痛是最突出的抱怨（均 p<0.001）。持续性疼痛（系数-11.3；p=0.02）、基于阿片类药物的疼痛治疗（系数-19.7；p<0.001）和酒精病因（系数-5.1；p=0.03）与较低的总体健康状况独立相关。最终的多变量模型解释了总体健康状况评分变异的 18%。
CP 患者的生活质量明显低于基于人群的参考人群。与降低的生活质量独立相关的因素是持续性疼痛、基于阿片类药物的疼痛治疗和酒精病因。然而，这些因素仅解释了生活质量的一小部分，还需要确定其他因素。
