Association of Chronic Pancreatitis Pain Features With Physical, Mental, and Social Health.
Association of Chronic Pancreatitis Pain Features With Physical, Mental, and Social Health.
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慢性胰腺炎疼痛特征与身体、心理和社会健康的关联。
DOI：
10.1016/j.cgh.2022.09.026
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
VanDenEeden,Ste
中科院分区：
文献类型：
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作者：
Yadav,Dhiraj;Askew,RobertL;Palermo,Tonya;Li,Liang;Andersen,DanaK;Chen,Minxing;Fisher,WilliamE;Fogel,EvanL;Forsmark,ChristopherE;Hart,PhilA;Othman,MohamedO;Pandol,StephenJ;Park,WalterG;Topazian,MarkD;VanDenEeden,Ste
背景和目的西班牙是慢性胰腺炎（CP）的主要症状。使用患者报告结果测量信息系统（PROMIS）测量方法，我们对一组明确定义的CP患者的身心健康和症状特征进行了描述，并将其与对照组进行了比较。在CP患者中，我们还研究了疼痛（强度、时间性质）和PROMIS症状特征以及临床显著心理合并症患病率之间的关系。方法：我们分析了488名慢性胰腺炎患者和254名对照组的基线数据，这些患者加入了一项正在进行的纵向队列研究PROCEED（慢性胰腺炎流行病学和转化研究的前瞻性评估）。参与者完成了记录全球身心健康状况的promise - global Health和记录7个症状域的promise -29概况。自我报告的疼痛按严重程度（无，轻度-中度，严重）和时间性质（无，间歇性，持续）分类。人口学和临床数据来自PROCEED数据库。结果西班牙与身心健康损害显著相关。与没有疼痛的参与者相比，在多变量模型中，剧烈疼痛（但不是轻-中度疼痛）的CP参与者在每个PROMIS域的下降更多（效应量，2.54-7.03），并且临床显著的抑郁，焦虑，睡眠障碍和身体残疾的患病率更高（优势比，2.11-4.74）。PROMIS域的持续疼痛（但不是间歇性疼痛）（效应值为4.08-10.37）和临床显著的抑郁、焦虑、睡眠障碍和身体残疾（优势比为2.80-5.38）也有类似的结果。结论严重和持续的疼痛是CP患者心理和身体健康状况不佳的主要驱动因素，应将精神合并症和睡眠障碍的系统评估和管理纳入CP患者的常规管理。
Background and AimsPain is a cardinal symptom of chronic pancreatitis (CP). Using Patient-Reported Outcomes Measurement Information System (PROMIS) measures, we characterized physical and mental health and symptom profiles of a well-defined cohort of individuals with CP and compared them with control subjects. Among patients with CP, we also examined associations between pain (intensity, temporal nature) and PROMIS symptom profiles and the prevalence of clinically significant psychological comorbidities.MethodsWe analyzed baseline data in 488 CP patients and 254 control subjects enrolled in PROCEED (Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies), an ongoing longitudinal cohort study. Participants completed the PROMIS-Global Health, which captures global physical and mental health, and the PROMIS-29 profile, which captures 7 symptom domains. Self-reported pain was categorized by severity (none, mild-moderate, severe) and temporal nature (none, intermittent, constant). Demographic and clinical data were obtained from the PROCEED database.ResultsPain was significantly associated with impairments in physical and mental health. Compared with participants with no pain, CP participants with severe pain (but not mild-moderate pain) had more decrements in each PROMIS domain in multivariable models (effect sizes, 2.54–7.03) and had a higher prevalence of clinically significant depression, anxiety, sleep disturbance, and physical disability (odds ratios, 2.11–4.74). Similar results were noted for constant pain (but not intermittent pain) for PROMIS domains (effect sizes, 4.08–10.37) and clinically significant depression, anxiety, sleep disturbance and physical disability (odds ratios, 2.80–5.38).ConclusionsSevere and constant pain are major drivers for poor psychological and physical health in CP. Systematic evaluation and management of psychiatric comorbidities and sleep disturbance should be incorporated into routine management of patients with CP. (ClinicalTrials.gov, Number: NCT03099850).