Symptom burden after acute pancreatitis and its correlation with exocrine pancreatic function: A multicenter prospective study.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Clinical and Translational Gastroenterology Pub Date : 2024-12-16 DOI:10.14309/ctg.0000000000000799

Joseph Bejjani, Stacey Culp, Melica Nikahd, Anna Evans Phillips, Vikesh Singh, Kristen M Roberts, Maisam Abu-El-Haija, Somashekar G Krishna, Mitchell L Ramsey, Ali Lahooti, Peter J Lee, Phil A Hart, Georgios I Papachristou

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Abstract

Background and aims: Gastrointestinal (GI) symptoms and weight loss develop during and after acute pancreatitis (AP), but remain understudied. In this prospective, multicenter study, we aim to assess GI symptom burden and weight loss and their correlation with exocrine function up to 12-mo post-AP.

Methods: GI symptom burden, anthropometrics, and exocrine pancreatic function were systematically measured in adults (≥18 years) with AP at predefined intervals: hospitalization (enrollment), 3-months (3-mo), and 12-mo post-AP. Symptoms were evaluated using a 15-item tracker, including abdominal symptoms, stool characteristics, and activities of daily living; higher scores indicating greater symptom burden (range 0-45). Exocrine function was assessed with fecal elastase-1 (FE-1) levels.

Results: GI symptoms were collected in 97 participants with 12-mo follow-up. The median (IQR) GI-symptom score was 7 (3-12) with 55 participants (57%) experiencing at least one symptom frequently ("often" or "almost always"). In multivariable linear regression, younger age, lower Charlson Comorbidity Index, smoking, recurrent AP, and alcoholic or idiopathic etiologies were associated with significantly higher GI-symptom burden at 12-mo. A significant negative correlation was found between GI symptoms and FE-1 levels during hospitalization ((ρ)=-0.288; p=0.015) and at 12-mo (ρ=-0.219; p=0.046). Eighteen participants (18.6%) lost ≥10% body weight between hospitalization and 12-mo, and had significantly lower median FE-1 levels at 12-mo compared to the group without weight-loss (166 vs. 332 µg/g, p=0.016).

Conclusions: This is the first study to prospectively assess GI-symptom burden and exocrine function post-AP. Lower exocrine pancreatic function at 12-mo was associated with increased symptom burden and weight loss. These findings support further investigations to define and improve patient-reported outcomes post-AP.

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背景和目的：急性胰腺炎（AP）期间和之后会出现胃肠道（GI）症状和体重减轻，但相关研究仍然不足。在这项前瞻性多中心研究中，我们旨在评估急性胰腺炎术后 12 个月内胃肠道症状负担和体重减轻情况及其与外分泌功能的相关性：在预定的时间间隔：住院（入院）、AP 术后 3 个月（3 个月）和 12 个月，对患有 AP 的成人（≥18 岁）的消化道症状负担、人体测量学和胰腺外分泌功能进行了系统测量。使用 15 个项目的追踪器评估症状，包括腹部症状、粪便特征和日常生活活动；得分越高表示症状负担越重（范围 0-45）。通过粪便弹性蛋白酶-1（FE-1）水平评估外分泌功能：结果：共收集了 97 名参与者的消化道症状，随访 12 个月。胃肠道症状得分的中位数（IQR）为 7（3-12），55 名参与者（57%）至少经常出现一种症状（"经常 "或 "几乎总是"）。在多变量线性回归中，年龄较小、夏尔森综合指数较低、吸烟、反复发作的 AP 以及酒精性或特发性病因与 12 个月时较高的消化道症状负担显著相关。住院期间（(ρ)=-0.288; p=0.015）和12个月后（ρ=-0.219; p=0.046），消化道症状与FE-1水平之间存在明显的负相关。18名参与者（18.6%）在住院至12个月期间体重下降了≥10%，与体重未下降组相比，他们在12个月时的FE-1中位数水平显著降低（166 vs. 332 µg/g，p=0.016）：这是第一项对AP术后消化道症状负担和外分泌功能进行前瞻性评估的研究。12个月时较低的胰腺外分泌功能与症状负担加重和体重减轻有关。这些发现支持进一步调查，以确定和改善AP术后患者报告的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.