Pancreatic function, quality of life and costs at long-term follow-up after acute pancreatitis.
OBJECTIVE
To evaluate long-term endocrine and exocrine pancreatic function, quality of life and health care costs after mild acute pancreatitis and severe acute pancreatitis (SAP).


METHODS
Patients prospectively included in 2001-2005 were followed-up after 42 (36-53) mo. Pancreatic function was evaluated with laboratory tests, the oral glucose tolerance test (OGTT), fecal elastase-1 and a questionnaire. Short Form (SF)-36, was completed.


RESULTS
Fourteen patients with a history of SAP and 26 with mild acute pancreatitis were included. Plasma glucose after OGTT was higher after SAP (9.2 mmol/L vs 7.0 mmol/L, P = 0.044). Diabetes mellitus or impaired glucose tolerance in fasting plasma glucose and/or 120 min plasma glucose were more common in SAP patients (11/14 vs 11/25, P = 0.037). Sick leave, time until the patients could take up recreational activities and time until they had recovered were all longer after SAP (P < 0.001). No significant differences in SF-36 were seen between the groups, or when comparing with age and gender matched reference groups. Total hospital costs, including primary care, follow-up and treatment of complications, were higher after SAP (median €16 572 vs €5000, P < 0.001).


CONCLUSIONS
Endocrine pancreatic function was affected, especially after severe disease. SAP requires greater resource use with long recovery, but most patients regained a good quality of life.
Department of Surgery, Clinical Sciences Lund, Lund University and Lund University Hospital, S-221 85 Lund, Sweden. bodil.andersson@med.lu.se
Bodil
B
Andersson
Marie-Louise
ML
Pendse
Roland
R
Andersson
D000208:Acute Disease; D000368:Aged; D016009:Chi-Square Distribution; D017281:Cost of Illness; D005243:Feces / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D017048:Health Care Costs; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism*; D010196:Pancreatic Elastase / Q000378:metabolism; D010195:Pancreatitis / Q000175:diagnosis / Q000191:economics / Q000378:metabolism / Q000523:psychology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D011998:Recreation; D012720:Severity of Illness Index; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013997:Time Factors
D010196:Pancreatic Elastase