Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities

Am J Gastroenterol. 2017 Apr;112(4):633-642. doi: 10.1038/ajg.2017.42. Epub 2017 Feb 28.


Objectives: Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients.

Methods: We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype, and treatments was obtained from responses to structured questionnaires. Physical and mental component summary (PCS and MCS, respectively) scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL.

Results: Mean PCS and MCS scores were 36.7±11.7 and 42.4±12.2, respectively. Significant (P<0.05) negative impact on PCS scores in multivariable analyses was noted owing to constant mild-moderate pain with episodes of severe pain or constant severe pain (10 points), constant mild-moderate pain (5.2), pain-related disability/unemployment (5.1), current smoking (2.9 points), and medical co-morbidities. Significant (P<0.05) negative impact on MCS scores was related to constant pain irrespective of severity (6.8-6.9 points), current smoking (3.9 points), and pain-related disability/unemployment (2.4 points). In women, disability/unemployment resulted in an additional 3.7 point reduction in MCS score. Final multivariable models explained 27% and 18% of the variance in PCS and MCS scores, respectively. Etiology, disease duration, pancreatic morphology, diabetes, exocrine insufficiency, and prior endotherapy/pancreatic surgery had no significant independent effect on QOL.

Conclusions: Constant pain, pain-related disability/unemployment, current smoking, and concurrent co-morbidities significantly affect the QOL in CP. Further research is needed to identify factors impacting QOL not explained by our analyses.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / physiopathology*
  • Adult
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Exocrine Pancreatic Insufficiency / etiology
  • Exocrine Pancreatic Insufficiency / physiopathology
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pain Measurement
  • Pancreatitis, Chronic / complications
  • Pancreatitis, Chronic / epidemiology
  • Pancreatitis, Chronic / physiopathology*
  • Pancreatitis, Chronic / psychology
  • Quality of Life*
  • Sex Factors
  • Sick Leave / statistics & numerical data*
  • Smoking / epidemiology*
  • Surveys and Questionnaires
  • Time Factors
  • Unemployment / statistics & numerical data*