Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis

Gregory A. Coté; Dhiraj Yadav; Judah A. Abberbock; David C. Whitcomb; Stuart Sherman; Bimaljit S. Sandhu; Michelle A. Anderson; Michele D. Lewis; Samer Alkaade; Vikesh K. Singh; John Baillie; Peter A. Banks; Darwin Conwell; Nalini M. Guda; Thiruvengadam Muniraj; Gong Tang; Randall Brand; Andres Gelrud; Stephen T. Amann; Christopher E. Forsmark; C. Mel Wilcox; Adam Slivka; Timothy B. Gardner

doi:10.1038/s41395-018-0087-7

Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis

Gregory A. Coté, Dhiraj Yadav, Judah A. Abberbock, David C. Whitcomb, Stuart Sherman, Bimaljit S. Sandhu, Michelle A. Anderson, Michele D. Lewis, Samer Alkaade, Vikesh K. Singh, John Baillie, Peter A. Banks, Darwin Conwell, Nalini M. Guda, Thiruvengadam Muniraj, Gong Tang, Randall Brand, Andres Gelrud, Stephen T. Amann, Christopher E. ForsmarkC. Mel Wilcox, Adam Slivka, Timothy B. Gardner

Internal Medicine

Research output: Contribution to journal › Article › peer-review

40 Scopus citations

Abstract

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.

Original language	English
Pages (from-to)	906-912
Number of pages	7
Journal	American Journal of Gastroenterology
Volume	113
Issue number	6
DOIs	https://doi.org/10.1038/s41395-018-0087-7
State	Published - Jun 1 2018

Bibliographical note

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.

ASJC Scopus subject areas

Hepatology
Gastroenterology

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10.1038/s41395-018-0087-7

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Coté, G. A., Yadav, D., Abberbock, J. A., Whitcomb, D. C., Sherman, S., Sandhu, B. S., Anderson, M. A., Lewis, M. D., Alkaade, S., Singh, V. K., Baillie, J., Banks, P. A., Conwell, D., Guda, N. M., Muniraj, T., Tang, G., Brand, R., Gelrud, A., Amann, S. T., ... Gardner, T. B. (2018). Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis. American Journal of Gastroenterology, 113(6), 906-912. https://doi.org/10.1038/s41395-018-0087-7

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title = "Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis",

abstract = "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.",

author = "Cot{\'e}, {Gregory A.} and Dhiraj Yadav and Abberbock, {Judah A.} and Whitcomb, {David C.} and Stuart Sherman and Sandhu, {Bimaljit S.} and Anderson, {Michelle A.} and Lewis, {Michele D.} and Samer Alkaade and Singh, {Vikesh K.} and John Baillie and Banks, {Peter A.} and Darwin Conwell and Guda, {Nalini M.} and Thiruvengadam Muniraj and Gong Tang and Randall Brand and Andres Gelrud and Amann, {Stephen T.} and Forsmark, {Christopher E.} and Wilcox, {C. Mel} and Adam Slivka and Gardner, {Timothy B.}",

note = "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: {\textcopyright} 2018 American College of Gastroenterology.",

year = "2018",

month = jun,

day = "1",

doi = "10.1038/s41395-018-0087-7",

language = "English",

volume = "113",

pages = "906--912",

number = "6",

}

Coté, GA, Yadav, D, Abberbock, JA, Whitcomb, DC, Sherman, S, Sandhu, BS, Anderson, MA, Lewis, MD, Alkaade, S, Singh, VK, Baillie, J, Banks, PA, Conwell, D, Guda, NM, Muniraj, T, Tang, G, Brand, R, Gelrud, A, Amann, ST, Forsmark, CE, Wilcox, CM, Slivka, A & Gardner, TB 2018, 'Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis', American Journal of Gastroenterology, vol. 113, no. 6, pp. 906-912. https://doi.org/10.1038/s41395-018-0087-7

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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ER -

Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis

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