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Patient reported outcomes after minimally invasive retroperitoneal pancreatic necrosectomy to treat acute pancreatitis - an exploratory study.
Journal of Digestive Diseases 2021 July 31
AIM: A minimally invasive retroperitoneal pancreatic necrosectomy (MIRPN) decreases morbidity and mortality from necrotizing acute pancreatitis. However, the impact of MIRPN on patient reported outcomes (PRO) was not investigated yet.
METHODS: Patients with acute pancreatitis who underwent MIRPN between January 2010 and December 2016 were identified and invited to participate completing the EORTC QLQ-C30 and EORTC PAN-28(CP) questionnaires. PROs were compared using Pearson correlation coefficient and ANOVA (significance p < 0.01) with an age- and sex-matched normative population of Western Europe and stratified by age and also the duration after MIRPN (<3y, >3y). A > 15 point change in PRO score was clinically important.
RESULTS: Among 52 eligible patients identified, 46 (88%) agreed to participate. 74% (n = 34) returned questionnaires. After MIRPN all patients reported poorer physical and social functioning scores with a clinically important (>15point) reduction in those ≤50 years old; whilst fatigue, pain and insomnia symptom scales had the highest scores(42,26 and 30 points respectively). Patients<3 year after MIRPN, had similar scores for all functional scales and global HRQL(health related quality of life) when compared to the normative data. However, with time global HRQOL deteriorated and by three years scores for functioning and symptoms were statistically(p < 0.0001) and clinically(>15 points) worse than age-matched controls.
CONCLUSION: Patients after MIRPN in first three years after the procedure have a relatively high QoL, though they experience higher symptom of fatigue. However, patients should be informed that HRQL deteriorates with time often due to chronic pancreatitis and pancreatic insufficiency. This study supports the use of MIRPN and prospective studies of HRQL in this setting are indicated. This article is protected by copyright. All rights reserved.
METHODS: Patients with acute pancreatitis who underwent MIRPN between January 2010 and December 2016 were identified and invited to participate completing the EORTC QLQ-C30 and EORTC PAN-28(CP) questionnaires. PROs were compared using Pearson correlation coefficient and ANOVA (significance p < 0.01) with an age- and sex-matched normative population of Western Europe and stratified by age and also the duration after MIRPN (<3y, >3y). A > 15 point change in PRO score was clinically important.
RESULTS: Among 52 eligible patients identified, 46 (88%) agreed to participate. 74% (n = 34) returned questionnaires. After MIRPN all patients reported poorer physical and social functioning scores with a clinically important (>15point) reduction in those ≤50 years old; whilst fatigue, pain and insomnia symptom scales had the highest scores(42,26 and 30 points respectively). Patients<3 year after MIRPN, had similar scores for all functional scales and global HRQL(health related quality of life) when compared to the normative data. However, with time global HRQOL deteriorated and by three years scores for functioning and symptoms were statistically(p < 0.0001) and clinically(>15 points) worse than age-matched controls.
CONCLUSION: Patients after MIRPN in first three years after the procedure have a relatively high QoL, though they experience higher symptom of fatigue. However, patients should be informed that HRQL deteriorates with time often due to chronic pancreatitis and pancreatic insufficiency. This study supports the use of MIRPN and prospective studies of HRQL in this setting are indicated. This article is protected by copyright. All rights reserved.
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