title: Prospective evaluation of quality of life in patients with Zollinger-Ellison syndrome.
abstract: BACKGROUND
  Zollinger-Ellison syndrome (ZES) is associated with complicated ulcer disease of the upper gastrointestinal tract. While management of ZES has dramatically improved with proton pump inhibitor therapy, quality of life in medically treated patients has not been evaluated.
  
  
  METHODS
  Over a 3-year period, 52 patients with ZES were prospectively evaluated at 6-month intervals with upper endoscopy and gastric acid analysis to evaluate the efficacy of current drug therapy and completion of SF36v2 forms. At each 6-month visit, patients' medication and problem lists were reviewed, comorbidities assessed, and any gastrointestinal symptoms recorded. Co-morbidity was represented as a simple illness count for the main analysis. The chronic disease score and the Charlson index were used for sensitivity analyses.
  
  
  RESULTS
  The unadjusted norm-based estimate of mental component score (MCS) for 52 patients with ZES (mean age 58, 65% male) was 49.8 (95% CI 46.4, 53.1). The unadjusted estimate of the physical component score (PCS) was 42.3 (95% CI 38.9, 45.7). As the number of illnesses or number of medications increased, there was a monotonic decrease in PCS scores. With multivariable adjustment, the coefficient for number of medications became non-significant. An increase in each of the co-morbidity indexes was associated with a decrease in PCS. Results did not vary by representation of co-morbidity. MCS was not significantly different from the general population.
  
  
  CONCLUSIONS
  Patients with medically managed ZES have norm-based estimates of the mental component scores as measured by the SF-36v2 that approximate normal values, while the physical component scores were decreased with this reduction largely explained by co-morbid illness.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 703 19th Street South, Birmingham, AL 35294-0007, USA. melw@uab.edu
authors.forename: George B
authors.initials: GB
authors.lastname: Smallfield
authors.forename: Jeroan
authors.initials: J
authors.lastname: Allison
authors.forename: C Mel
authors.initials: CM
authors.lastname: Wilcox
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D015043:Zollinger-Ellison Syndrome / Q000188:drug therapy / Q000453:epidemiology
references.citation: J Gerontol A Biol Sci Med Sci. 2007 Mar;62(3):281-5
references.pmid: 17389725
references.citation: Dig Dis Sci. 2001 Nov;46(11):2416-23
references.pmid: 11713946
references.citation: J Clin Epidemiol. 2008 Dec;61(12):1234-1240
references.pmid: 18619805
references.citation: N Engl J Med. 1980 Jun 12;302(24):1344-7
references.pmid: 6990258
references.citation: Gastroenterology. 1992 Mar;102(3):767-78
references.pmid: 1537514
references.citation: Health Qual Life Outcomes. 2007 Aug 06;5:52
references.pmid: 17683600
references.citation: Ann Surg. 1955 Oct;142(4):709-23; discussion, 724-8
references.pmid: 13259432
references.citation: World J Gastroenterol. 2005 Sep 21;11(35):5423-32
references.pmid: 16222731
references.citation: BMJ. 1992 Jul 18;305(6846):160-4
references.pmid: 1285753
references.citation: Clin Gastroenterol Hepatol. 2005 Jan;3(1):39-48
references.pmid: 15645403
references.citation: J Clin Epidemiol. 1992 Feb;45(2):197-203
references.pmid: 1573438
references.citation: J Chronic Dis. 1987;40(5):373-83
references.pmid: 3558716
references.citation: Ann Surg. 2006 Sep;244(3):410-9
references.pmid: 16926567
references.citation: Med Care. 2003 May;41(5):582-92
references.pmid: 12719681