Pancreatic function, quality of life and costs at long-term follow-up after acute pancreatitis

World J Gastroenterol. 2010 Oct 21;16(39):4944-51. doi: 10.3748/wjg.v16.i39.4944.

Abstract

Aim: To evaluate long-term endocrine and exocrine pancreatic function, quality of life and health care costs after mild acute pancreatitis and severe acute pancreatitis (SAP).

Methods: Patients prospectively included in 2001-2005 were followed-up after 42 (36-53) mo. Pancreatic function was evaluated with laboratory tests, the oral glucose tolerance test (OGTT), fecal elastase-1 and a questionnaire. Short Form (SF)-36, was completed.

Results: Fourteen patients with a history of SAP and 26 with mild acute pancreatitis were included. Plasma glucose after OGTT was higher after SAP (9.2 mmol/L vs 7.0 mmol/L, P = 0.044). Diabetes mellitus or impaired glucose tolerance in fasting plasma glucose and/or 120 min plasma glucose were more common in SAP patients (11/14 vs 11/25, P = 0.037). Sick leave, time until the patients could take up recreational activities and time until they had recovered were all longer after SAP (P < 0.001). No significant differences in SF-36 were seen between the groups, or when comparing with age and gender matched reference groups. Total hospital costs, including primary care, follow-up and treatment of complications, were higher after SAP (median €16 572 vs €5000, P < 0.001).

Conclusion: Endocrine pancreatic function was affected, especially after severe disease. SAP requires greater resource use with long recovery, but most patients regained a good quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Chi-Square Distribution
  • Cost of Illness
  • Feces / enzymology
  • Female
  • Follow-Up Studies
  • Glucose Tolerance Test
  • Health Care Costs*
  • Humans
  • Italy
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Pancreas / metabolism*
  • Pancreatic Elastase / metabolism
  • Pancreatitis* / diagnosis
  • Pancreatitis* / economics
  • Pancreatitis* / metabolism
  • Pancreatitis* / psychology
  • Predictive Value of Tests
  • Prospective Studies
  • Quality of Life*
  • Recovery of Function
  • Recreation
  • Severity of Illness Index
  • Sick Leave
  • Surveys and Questionnaires
  • Time Factors

Substances

  • Pancreatic Elastase