Abstracts: Abstracts of Papers Submitted to the American Pancreatic Association: November 4–5, 2004, Chicago, Illinois
Introduction: Health-related quality of life is becoming a major issue in the evaluation of any therapeutic intervention in patients with chronic diseases.
Aim: To assess the quality of life in a large group of patients with chronic pancreatitis.
Subjects and Methods: A total of 190 consecutive patients (157 M, 33 F; mean age 58.6 years, range 18–92) with proven chronic pancreatitis were studied. The mean age of onset of the pancreatitis was 42.3±14.8 years and the mean time interval between diagnosis and admission to the study was 201±141 months (range 0–629 months). The etiology was alcohol abuse in 147 patients (77.4%), due to other causes in 11 (5.8%); in the remaining 32 patients (16.8%), the pancreatitis was idiopathic. Fifty-two patients of the 147 drinkers (35.4%) continued to drink alcohol after the diagnosis of chronic pancreatitis. One hundred and forty-seven patients (77.4%) were smokers and 89 of them (60.5%) continued to smoke at the time of the study. One hundred and twenty-four patients (65.3%) had pancreatic calcification, 75 (39.5%) had pseudo-cysts, and 133 (70.0%) had a dilatation of the Wirsung duct. Fecal elastase and/or fecal chymotrypsin were evaluated in 94 patients; 80 of them (85.1%) had pancreatic insufficiency. One hundred patients (52.6%) had diabetes secondary to pancreatitis. Eighty patients (42.1%) had had pancreatic surgery for chronic pancreatitis and 16 (8.4%) underwent endotherapy. A histological diagnosis of chronic pancreatitis was available in 79 patients (41.6%). Sixty-five patients (34.2%) had pancreatic pain in the month before the study enrollment. The SF-36 questionnaire was used for assessing the health-related quality of life.
Results: The z-scores of the 8 domains of the patients with chronic pancreatitis were significantly negative indicating an overall impairment of the quality of life when compared to the Italian normative sample. Pancreatic pain was the unique clinical variable able to significantly impair all 8 domains of the SF-36, while Wirsung dilation and diabetes were negatively related to some physical and mental domains. Body mass index was the unique variable positively related with some SF-36 domains.
Conclusions: Pain may be considered the most important factor affecting the quality of life of chronic pancreatitis patients.