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
{"title":"Symptom burden after acute pancreatitis and its correlation with exocrine pancreatic function: A multicenter prospective study.","authors":"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","doi":"10.14309/ctg.0000000000000799","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Translational Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.14309/ctg.0000000000000799","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Symptom burden after acute pancreatitis and its correlation with exocrine pancreatic function: A multicenter prospective study.
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.
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.