Physical and mental quality of life in chronic pancreatitis: a case-control study from the North American Pancreatitis Study 2 cohort

Abstract

Objectives: The objective of this study was to define the quality of life (QOL) in patients with chronic pancreatitis (CP).

Methods: We studied 443 well-phenotyped CP subjects and 611 control subjects prospectively enrolled from 20 US centers between 2000 and 2006 in the North American Pancreatitis Study 2. Responses to the SF-12 questionnaire were used to calculate the mental (MCS) and physical component summary scores (PCS) with norm-based scoring (normal ≥50). Quality of life in CP subjects was compared with control subjects after controlling for demographic factors, drinking history, smoking, and medical conditions. Quality of life in CP was also compared with known scores for several chronic conditions.

Results: Both PCS (38 [SD, 11.5] vs 52 [SD, 9.4]) and MCS (44 [SD, 11.5] vs 51 [SD, 9.2]) were significantly lower in CP compared with control subjects (P < 0.001). On multivariable analyses, compared with control subjects, a profound decrease in physical QOL (PCS 12.02 points lower) and a clinically significant decrease in mental QOL (MCS 4.24 points lower) was seen due to CP. Quality of life in CP was similar to (heart, kidney, liver, lung disease) or worse than (nonskin cancers, diabetes mellitus, hypertension, rheumatoid arthritis) other chronic conditions.

Conclusions: The impact of CP on QOL appears substantial. The QOL in CP subjects appears to be worse or similar to the QOL of many other chronic conditions.

Figure 1

Quality of life scores for controls (population, NAPS2) and chronic pancreatitis patients in the NAPS2 study 1a) MCS 1b) PCS

Figure 1

Quality of life scores for controls (population, NAPS2) and chronic pancreatitis patients in the NAPS2 study 1a) MCS 1b) PCS

Figure 2

Quality of life scores for chronic pancreatitis patients in the NAPS2 study compared with other chronic conditions 2a) MCS 2b) PCS

Figure 2

Quality of life scores for chronic pancreatitis patients in the NAPS2 study compared with other chronic conditions 2a) MCS 2b) PCS

Figure 3

Incremental decrease in quality of life scores with additional attributes in a representative control and chronic pancreatitis patient. A PCS or MCS score of 50 (dark solid line in the graphs) is considered to represent an average (normal) score for a population control. 3a) Physical quality of life: PCS scores in –

1. 50 year old Caucasian control or chronic pancreatitis patient with BMI of 25 who is a lifetime abstainer, non-smoker and has no history of diabetes, heart attack/stroke or gallstones/gallbladder removal

2. Subject in A who is also a current smoker

3. Subject in B who also has diabetes

4. Subject in C who also has a history of heart attack or stroke and gallstones or gallbladder removal

3b) Mental quality of life: MCS scores in –

1. 50 year old Caucasian control or chronic pancreatitis patient with BMI of 25 who is a lifetime abstainer, non-smoker and has no history of diabetes, heart attack/stroke or gallstones/gallbladder removal

2. Subject in A who is also a current smoker

3. Subject in B who also has a history of heart attack or stroke

4. Subject in C who also has a history of diabetes and gallstones or gallbladder removal

Figure 3

Incremental decrease in quality of life scores with additional attributes in a representative control and chronic pancreatitis patient. A PCS or MCS score of 50 (dark solid line in the graphs) is considered to represent an average (normal) score for a population control. 3a) Physical quality of life: PCS scores in –

1. 50 year old Caucasian control or chronic pancreatitis patient with BMI of 25 who is a lifetime abstainer, non-smoker and has no history of diabetes, heart attack/stroke or gallstones/gallbladder removal

2. Subject in A who is also a current smoker

3. Subject in B who also has diabetes

4. Subject in C who also has a history of heart attack or stroke and gallstones or gallbladder removal

3b) Mental quality of life: MCS scores in –

1. 50 year old Caucasian control or chronic pancreatitis patient with BMI of 25 who is a lifetime abstainer, non-smoker and has no history of diabetes, heart attack/stroke or gallstones/gallbladder removal

2. Subject in A who is also a current smoker

3. Subject in B who also has a history of heart attack or stroke

4. Subject in C who also has a history of diabetes and gallstones or gallbladder removal