Pain and aetiological risk factors determine quality of life in patients with chronic pancreatitis, but a brick in the puzzle is missing

Pancreatology. 2020 Oct;20(7):1347-1353. doi: 10.1016/j.pan.2020.09.004. Epub 2020 Sep 10.

Abstract

Background and objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Chronic pancreatitis; Determinants; Inflammation; Quality of life; Risk factors; Smoking.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking
  • Analgesics, Opioid / therapeutic use
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Pain / complications*
  • Pain / drug therapy
  • Pancreatitis, Alcoholic / complications
  • Pancreatitis, Alcoholic / psychology
  • Pancreatitis, Chronic / complications*
  • Pancreatitis, Chronic / psychology*
  • Quality of Life
  • Risk Factors
  • Smoking
  • Surveys and Questionnaires

Substances

  • Analgesics, Opioid