Pain severity reduces life quality in chronic pancreatitis: Implications for design of future outcome trials
Pain severity reduces life quality in chronic pancreatitis: Implications for design of future outcome trials
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DOI：
10.1016/j.pan.2014.09.009
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发表时间：
2014-11-01
期刊：
影响因子：
3.6
通讯作者：
Drewes, Asbjorn Mohr
中科院分区：
文献类型：
--
作者：
Olesen, Soren Schou;Juel, Jacob;Drewes, Asbjorn Mohr
背景/目标：慢性胰腺炎（CP）是一种致残性疾病，其特征是腹痛，以及各种胰腺和胰腺外并发症。我们调查了疼痛的特点（即疼痛的严重程度及其模式的时间），并发症，和生活质量（QOL）在CP患者之间的相互作用。方法：这是一个横断面研究106例CP在两个北欧三级医疗中心进行。通过访谈和对个体患者记录的审查获得了关于临床患者特征的详细信息。从改良的简明疼痛量表简表中提取疼痛严重程度评分和疼痛模式时间曲线，并与EORTC QLQ-C30问卷评估的QOL相关。结果：疼痛是本组患者最突出的症状，其严重程度与EORTC总体健康状况（r = -0.46; P < 0.001）以及大多数功能和症状分量表显著相关。相比之下，疼痛的时间模式与任何生活质量子量表都不相关。当控制外分泌和内分泌胰腺功能不全的相互作用时，没有明显的影响改变（P = 0.72和P = 0.85），而胰腺和胰腺外并发症的存在与生活质量下降近15%相关（P = 0.004）。结论：疼痛严重程度和疾病相关并发症显著降低CP患者的生活质量。这些信息对于在未来的结局试验中设计更准确和有临床意义的终点非常重要。版权所有（C）2014，IAP和EPC。由爱思唯尔印度出版，里德爱思唯尔印度私人有限公司的一个部门。保留所有权利。
Background/objectives: Chronic pancreatitis (CP) is a disabling disease characterised by abdominal pain, and various pancreatic and extra-pancreatic complications. We investigated the interactions between pain characteristics (i.e. pain severity and its pattern in time), complications, and quality of life (QOL) in patients with CP.Methods: This was a cross-sectional study of 106 patients with CP conducted at two North European tertiary medical centres. Detailed information on clinical patient characteristics was obtained from interviews and through review of the individual patient records. Pain severity scores and pain pattern time profiles were extracted from the modified brief pain inventory short form and correlated to QOL as assessed by the EORTC QLQ-C30 questionnaire. Interactions with exocrine and endocrine pancreatic insufficiency, as well as pancreatic and extra-pancreatic complications were analysed using regression models.Results: Pain Was the most prominent symptom in our cohort and its severity was significantly correlated with EORTC global health status (r = -0.46; P < 0.001) and most functional and symptom subscales. In contrast the patterns of pain in time were not associated with any of the life quality subscales. When controlling for interactions from exocrine and endocrine pancreatic insufficiency no effect modifications were evident (P = 0.72 and P = 0.85 respectively), while the presence of pancreatic and extra-pancreatic complications was associated with an almost 15% decrease in life quality (P = 0.004).Conclusions: Pain severity and disease related complications significantly reduce life quality in patients with CP. This information is important in order to design more accurate and clinical meaningful endpoints in future outcome trials. Copyright (C) 2014, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.