Type of pain, pain-associated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study.
Type of pain, pain-associated complications, quality of life, disability and resource utilisation in chronic pancreatitis: a prospective cohort study.
复制标题
DOI：
10.1136/gut.2010.213835
复制
发表时间：
2011-01
期刊：
影响因子：
24.5
通讯作者：
NAPS2 Consortium
中科院分区：
文献类型：
--
作者：
Mullady DK;Yadav D;Amann ST;O'Connell MR;Barmada MM;Elta GH;Scheiman JM;Wamsteker EJ;Chey WD;Korneffel ML;Weinman BM;Slivka A;Sherman S;Hawes RH;Brand RE;Burton FR;Lewis MD;Gardner TB;Gelrud A;DiSario J;Baillie J;Banks PA;Whitcomb DC;Anderson MA;NAPS2 Consortium
比较慢性胰腺炎（CP）患者的持续性疼痛模式与间歇性疼痛模式。这是一项在美国20家三级医疗中心进行的前瞻性队列研究，包括540例CP受试者。CP患者被要求从五种疼痛模式（A-E）中识别他们的疼痛，这些疼痛模式由疼痛的时间性质（间歇性或持续性）和疼痛的严重程度（轻度、中度或重度）定义。疼痛模式类型进行了比较方面的各种人口统计学，生活质量（QOL）和临床参数。残疾率是主要结局。次要结局包括：使用止痛药、失学或误工天数、住院（前一年和一生）和使用简明健康调查表（SF-12）问卷测量的QOL。在540名CP患者中，414名患者（77%）自我识别出特定的疼痛模式并进行了分析。持续疼痛的患者，无论严重程度如何，其残疾率、住院率和止痛药使用率都高于间歇性疼痛的患者。与间歇性疼痛患者相比，持续性疼痛患者的生活质量较低（SF-12）。此外，持续疼痛的患者更有可能将酒精作为胰腺炎的病因。疾病的持续时间与疼痛的质量或严重程度之间没有关联。这是有史以来对CP疼痛进行的最大规模的研究。这些研究结果表明，疼痛的时间性质是一个更重要的决定因素，健康相关的生活质量和医疗保健利用比疼痛的严重程度。与以前的研究相反，与CP相关的疼痛没有发现随着时间的推移而改变质量。这些结果对于提高我们对CP疼痛机制的理解以及未来治疗和干预的目标具有重要意义。
To compare patients with chronic pancreatitis (CP) with constant pain patterns to patients with CP with intermittent pain patterns. This was a prospective cohort study conducted at 20 tertiary medical centers in the USA comprising 540 subjects with CP. Patients with CP were asked to identify their pain from five pain patterns (A—E) defined by the temporal nature (intermittent or constant) and the severity of the pain (mild, moderate or severe). Pain pattern types were compared with respect to a variety of demographic, quality of life (QOL) and clinical parameters. Rates of disability were the primary outcome. Secondary outcomes included: use of pain medications, days lost from school or work, hospitalisations (preceding year and lifetime) and QOL as measured using the Short Form-12 (SF-12) questionnaire. Of the 540 CP patients, 414 patients (77%) self-identified with a particular pain pattern and were analysed. Patients with constant pain, regardless of severity, had higher rates of disability, hospitalisation and pain medication use than patients with intermittent pain. Patients with constant pain had lower QOL (by SF-12) compared with patients who had intermittent pain. Additionally, patients with constant pain were more likely to have alcohol as the aetiology for their pancreatitis. There was no association between the duration of the disease and the quality or severity of the pain. This is the largest study ever conducted of pain in CP. These findings suggest that the temporal nature of pain is a more important determinant of health-related QOL and healthcare utilisation than pain severity. In contrast to previous studies, the pain associated with CP was not found to change in quality over time. These results have important implications for improving our understanding of the mechanisms underlying pain in CP and for the goals of future treatments and interventions.
登录
查看更多内容
影响因子：
7.4
作者：
Nicholl BI;Macfarlane GJ;Davies KA;Morriss R;Dickens C;McBeth J
通讯作者：
McBeth J
影响因子：
7
作者：
Hawker, G. A.;Stewart, L.;Gooberman-Hill, R.
通讯作者：
Gooberman-Hill, R.
影响因子：
7.4
作者：
Eisenach, JC;Carpenter, R;Curry, R
通讯作者：
Curry, R
影响因子：
7.4
作者：
JENSEN, MP;MCFARLAND, CA
通讯作者：
MCFARLAND, CA
影响因子：
7.2
作者：
Gandek, B;Ware, JE;Sullivan, M
通讯作者：
Sullivan, M