Skip to main content
Log in

Quality of life and functional outcome at 3, 6 and 12 months after acute necrotising pancreatitis

  • Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Purpose

To prospectively determine the quality of life and functional outcome at 3, 6 and 12 months following acute necrotising pancreatitis.

Methods

Thirty-one consecutive patients with acute necrotising pancreatitis requiring intensive care in our hospital were identified. Survivors were assessed at 3, 6 and 12 months following hospital discharge by an investigator blinded to their previous treatment. Health-related quality of life was assessed by the Short Form 36 (SF-36) questionnaire and functional outcome by the six minute walk test.

Results

Twenty-one patients (68%) survived to leave hospital. The median score for the physical function domain increased from 32 at 3 months to 38 and 12 months (P = 0.013), but remained lower than the score in the normal population of 88 (P < 0.001). The median physical component summary score increased from 33 at 3 months to 40 at 12 months (P = 0.030), but remained lower than the score in the normal population of 50 (P = 0.009). Between 3 and 12 months the median distance walked in 6-min increased from 358 to 424 m (P = 0.021), but remained lower than the predicted distance of 503 m (P = 0.014).

Conclusions

In the first year after acute necrotising pancreatitis patients showed improvement in their physical components of quality of life and in their physical function, but their outcome at 12 months was still poor compared to the general population. This patient group in particular may benefit from a structured rehabilitation programme continuing after hospital discharge.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Whitcomb DC (2006) Clinical practice: acute pancreatitis. N Engl J Med 354:2142–2150

    Article  PubMed  Google Scholar 

  2. Fenton-Lee D, Imrie CW (1993) Pancreatic necrosis: assessment of outcome related to quality of life and cost of management. Br J Surg 80:1579–1582

    Article  CAS  PubMed  Google Scholar 

  3. Broome AH, Eisen GM, Harland RC, Collins BH, Meyers WC, Pappas TN (1996) Quality of life after treatment for pancreatitis. Ann Surg 223:665–670

    Article  CAS  PubMed  Google Scholar 

  4. Kriwanek S, Armbruster C, Dittrich K, Beckerhinn P, Schwarzmaier A, Redl E (1998) Long-term outcome after open treatment of severe intra-abdominal infection and pancreatic necrosis. Arch Surg 133:140–144

    Article  CAS  PubMed  Google Scholar 

  5. Bosscha K, Reijnders K, Jacobs MH, Post MW, Algra A, van der Werken C (2001) Quality of life after severe bacterial peritonitis and infected necrotizing pancreatitis treated with open management of the abdomen and planned re-operations. Crit Care Med 29:1539–1543

    Article  CAS  PubMed  Google Scholar 

  6. Cinquepalmi L, Boni L, Dionigi G, Rovera F, Diurni M, Benevento A, Dionigi R (2006) Long-term results and quality of life of patients undergoing sequential surgical treatment for severe acute pancreatitis complicated by infected pancreatic necrosis. Surg Infect 7(Suppl 2):S113–S116

    Google Scholar 

  7. Hochman D, Louie B, Bailey R (2006) Determination of patient quality of life following severe acute pancreatitis. Can J Surg 49:101–106

    PubMed  Google Scholar 

  8. Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S, Stewart TE, Barr A, Cook D, Slutsky AS, Canadian Critical Care Trials Group (2003) One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 348:683–693

    Article  PubMed  Google Scholar 

  9. Chelluri L, Im KA, Belle SH, Schulz R, Rotondi AJ, Donahoe MP, Sirio CA, Mendelsohn AB, Pinsky MR (2004) Long-term mortality and quality of life after prolonged mechanical ventilation. Crit Care Med 32:61–69

    Article  PubMed  Google Scholar 

  10. Bradley EL (1993) A clinically based classification system for acute pancreatitis. Arch Surg 128:586–590

    PubMed  Google Scholar 

  11. Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH (1990) Acute pancreatitis: value of CT in establishing prognosis. Radiology 174:331–336

    CAS  PubMed  Google Scholar 

  12. Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  13. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories (2002) ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166:111–117

    Google Scholar 

  14. Jenkinson C, Stewart-Brown S, Petersen S, Paice C (1999) Assessment of the SF-36 version 2 in the United Kingdom. J Epidemiol Community Health 53:46–50

    Article  CAS  PubMed  Google Scholar 

  15. Enright PL, Sherrill DL (1998) Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med 158:1384–1387

    CAS  PubMed  Google Scholar 

  16. Ellis MP, French JJ, Charnley RM (2009) Acute pancreatitis and the influence of socioeconomic deprivation. Br J Surg 96:74–80

    Article  CAS  PubMed  Google Scholar 

  17. Cote CG, Pinto-Plata V, Kasprzyk K, Dordelly LJ, Celli BR (2007) The 6-min walk distance, peak oxygen uptake, and mortality in COPD. Chest 132:1778–1785

    Article  PubMed  Google Scholar 

  18. Redelmeier DA, Bayoumi AM, Goldstein RS, Guyatt GH (1997) Interpreting small differences in functional status: the six minute walk test in chronic lung disease patients. Am J Respir Crit Care Med 155:1278–1282

    CAS  PubMed  Google Scholar 

  19. Dempsey JA, Wagner PD (1999) Exercise-induced arterial hypoxemia. J Appl Physiol 87:1997–2006

    CAS  PubMed  Google Scholar 

  20. National Institute for Health and Clinical Excellence (2008) Rehabilitation after critical illness, clinical guideline. http://www.nice.org.uk/Guidance/CG83. Accessed 25 March 2009

Download references

Acknowledgments

We thank the physiotherapists of the Department of Rehabilitation, Freeman Hospital, for supervising the six minute walk tests, Rita Singh and Christine Straughan for help with data collection, and Tom Chadwick for statistical advice. The licence fee required by QualityMetric Incorporated for use of the SF-36 (licence number H1-100104-20139) was purchased with charitable funds from the Department of Surgery, Freeman Hospital.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephen E. Wright.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wright, S.E., Lochan, R., Imrie, K. et al. Quality of life and functional outcome at 3, 6 and 12 months after acute necrotising pancreatitis. Intensive Care Med 35, 1974–1978 (2009). https://doi.org/10.1007/s00134-009-1616-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-009-1616-z

Keywords

Navigation