Geographic Differences in the Quality of Life Associated With Chronic Pancreatitis: An International, Multicenter Study.

BACKGROUND AND AIMS: Chronic pancreatitis (CP) is a disease that is present in multiple different geographic populations and is treated similarly around the world. No study has directly compared geographic differences in clinical characteristics of CP populations from Western and other regions, nor quality of life experiences.

METHODS

This cross-sectional, multicenter study of adults (≥18 years) with definite CP recruited subjects at 4 centers from the Pancreatic Pain Consortium. Demographics, clinical and disease characteristics, and patient-reported outcomes, including Hospital Anxiety and Depression Scale and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 scores were obtained. Due to similarities in population characteristics, European and United States subjects were grouped together into a Western population.

RESULTS

A total of 528 subjects were included (Indian n = 254, Western n = 274). Compared to the Indian cohort, the Western cohort had higher mean age at enrollment (54.5 ± 13.5 v 35.9 ± 11.8 years), older age distribution, higher rates of current alcohol use (34% v 2%) and alcohol etiology of CP (53% v 17%), more constant pain (50% v 20%), higher prevalence of exocrine pancreatic insufficiency (66% v 44%), and higher rates of endoscopic treatment (61% v 43%) (all P < .001). The Western cohort also reported lower global health and worse scores in physical, role, cognitive, and social functioning with a reduction in overall global health in multivariable regression analyses (-7.2 points [95% confidence interval -13.5 to -1.0] P = .023).

CONCLUSION

There appear to be demographic, etiological, and quality of life differences in the experience of CP across different populations. Reasons for these differences, including potential cultural and societal forces, need to be further explored.