QUALITY OF LIFE IN PATIENTS WITH CHRONIC PANCREATITIS: A NATIONWIDE LONGITUDINAL COHORT STUDY

Background Chronic pancreatitis (CP) may severely impact quality of life (QoL). Since CP is a chronic condition, multiple assessments of QoL are required to obtain a thorough understanding of its impact on patients. Such studies are currently lacking. Therefore, the aim of the present study is to gain insight into the course and predictors of both physical and mental QoL in patients with CP using prospective longitudinal data from a large cohort of patients.
Methods Post-hoc analysis of patients with CP registered in a prospective database between 2011 and 2019. Patient and disease characteristics, nutritional status, pain severity, medication usage, pancreatic function and pancreatic interventions were assessed from patients’ medical records and through standard follow-up questionnaires. The physical (PCS) and mental component summary (MCS) scales of the Short-Form 36 were used to assess QoL at baseline and during follow-up. The course of both physical and mental QoL and their associated factors were longitudinally assessed by using generalized linear mixed models (GLMM).
Results Overall, 1,165 patients with CP were included for this analysis. During 10-year follow-up, GLMM analyses revealed improvements in both PCS (41.6 to 45.1, p < .001) and MCS (45.8 to 48.5, P = 0.041). Older age, no alcohol consumption, unemployment, need for dietetic consultation, steatorrhea, higher Izbicki pain score and pain coping mechanism were negatively associated with physical QoL (P < .05). For mental QoL, a positive correlation was found between employment, non-alcoholic CP, no need for dietetic consultation, no steatorrhea, lower Izbicki pain score, pain coping mechanism and surgical treatment. No association was observed between disease duration and longitudinal QoL per patient.
Conclusions The present study provides insight into the dynamics of physical and mental QoL in patients with CP over time. Important and potentially influenceable factors to improve QoL in patients with CP are nutritional status, exocrine pancreatic function, employment status, and patients’ coping strategy.