Abstract：
OBJECTIVE: The impact of chronic pancreatitis (CP) on quality of life (QOL) of children is not well established. Our objective was to evaluate the QOL, identify contributing factors, and determine the prevalence of anxiety and depression in children with CP in India.
METHODS: Children (8-18y old) with CP were prospectively enrolled across three pediatric gastroenterology centres in India. QOL was assessed using the pediatric QOL inventory (PedsQL 4.0) scale, administered to both children and their parents. Anxiety and depression was studied using the Revised Children\'s Anxiety and Depression Scale (RCADS 25). Contributing factors were identified using binary logistic regression analysis. The data was compared against published QOL data in healthy Indian children.
RESULTS: 121 children with CP (boys-57.9 %, age at QOL-14 ± 3.2years) were enrolled. A majority (82.7 %) had pain and advanced disease (Cambridge grade IV- 63.6 %). Children with CP had poorer QOL compared to controls (total score 74.6 ± 16 vs. 87.5 ± 11.1, p < 0.0001). QOL scores were similar across centres. Older children were similar to younger ones, except for a poorer emotional QOL. Taking QOL < -2 standard deviation (SD) of controls, ∼35 % had poor physical (50.9 ± 11.9) and 20 % had poor psychosocial (PS) QOL score (52.1 ± 7.2). On analysis, presence of pain and lower socio-economic status (SES) adversely affected both physical and PS-QOL. Additionally, girls had poorer PS-QOL than boys (Odds ratio 3.1, 95%CI:1.23-7.31). Anxiety and depression were uncommon (2,1.6 %).
CONCLUSIONS: Patients with CP had impaired physical and psycho-social QOL. Presence of pain and lower SES adversely affected QOL. Psychiatric comorbidities were uncommon.
METHODS: Children (8-18y old) with CP were prospectively enrolled across three pediatric gastroenterology centres in India. QOL was assessed using the pediatric QOL inventory (PedsQL 4.0) scale, administered to both children and their parents. Anxiety and depression was studied using the Revised Children\'s Anxiety and Depression Scale (RCADS 25). Contributing factors were identified using binary logistic regression analysis. The data was compared against published QOL data in healthy Indian children.
RESULTS: 121 children with CP (boys-57.9 %, age at QOL-14 ± 3.2years) were enrolled. A majority (82.7 %) had pain and advanced disease (Cambridge grade IV- 63.6 %). Children with CP had poorer QOL compared to controls (total score 74.6 ± 16 vs. 87.5 ± 11.1, p < 0.0001). QOL scores were similar across centres. Older children were similar to younger ones, except for a poorer emotional QOL. Taking QOL < -2 standard deviation (SD) of controls, ∼35 % had poor physical (50.9 ± 11.9) and 20 % had poor psychosocial (PS) QOL score (52.1 ± 7.2). On analysis, presence of pain and lower socio-economic status (SES) adversely affected both physical and PS-QOL. Additionally, girls had poorer PS-QOL than boys (Odds ratio 3.1, 95%CI:1.23-7.31). Anxiety and depression were uncommon (2,1.6 %).
CONCLUSIONS: Patients with CP had impaired physical and psycho-social QOL. Presence of pain and lower SES adversely affected QOL. Psychiatric comorbidities were uncommon.
摘要：
目的：慢性胰腺炎（CP）对儿童生活质量（QOL）的影响尚不明确。我们的目标是评估生活质量，找出促成因素，并确定印度CP儿童的焦虑和抑郁患病率。
方法：在印度的三个儿科胃肠病中心，前瞻性地纳入患有CP的儿童（8-18岁）。使用儿科QOL量表(PedsQL4.0)评估QOL，给孩子和他们的父母。采用修订的儿童焦虑抑郁量表(RCADS25)对焦虑抑郁进行研究。使用二元逻辑回归分析确定影响因素。将该数据与健康印度儿童的QOL数据进行了比较。
结果：121名CP儿童（男孩-57.9％，纳入年龄为QOL-14±3.2岁)。大多数（82.7％）患有疼痛和晚期疾病（剑桥IV级-63.6％）。与对照组相比，CP患儿的生活质量较差（总分74.6±16vs.87.5±11.1，p<0.0001）。各中心的QOL得分相似。年龄较大的孩子与年龄较小的孩子相似，除了较差的情绪QOL。以对照的QOL<-2标准差(SD)为例，35%的人体质差(50.9±11.9)，20%的人心理社会(PS)生活质量评分差(52.1±7.2)。在分析中，疼痛的存在和较低的社会经济地位(SES)对身体和PS-QOL都有不利影响。此外,女孩的PS-QOL比男孩差(赔率比3.1,95CI:1.23-7.31)。焦虑和抑郁并不常见（2,1.6％）。
结论：CP患者的身体和心理社会生活质量受损。疼痛的存在和较低的SES对生活质量产生不利影响。精神病合并症并不常见。
方法：在印度的三个儿科胃肠病中心，前瞻性地纳入患有CP的儿童（8-18岁）。使用儿科QOL量表(PedsQL4.0)评估QOL，给孩子和他们的父母。采用修订的儿童焦虑抑郁量表(RCADS25)对焦虑抑郁进行研究。使用二元逻辑回归分析确定影响因素。将该数据与健康印度儿童的QOL数据进行了比较。
结果：121名CP儿童（男孩-57.9％，纳入年龄为QOL-14±3.2岁)。大多数（82.7％）患有疼痛和晚期疾病（剑桥IV级-63.6％）。与对照组相比，CP患儿的生活质量较差（总分74.6±16vs.87.5±11.1，p<0.0001）。各中心的QOL得分相似。年龄较大的孩子与年龄较小的孩子相似，除了较差的情绪QOL。以对照的QOL<-2标准差(SD)为例，35%的人体质差(50.9±11.9)，20%的人心理社会(PS)生活质量评分差(52.1±7.2)。在分析中，疼痛的存在和较低的社会经济地位(SES)对身体和PS-QOL都有不利影响。此外,女孩的PS-QOL比男孩差(赔率比3.1,95CI:1.23-7.31)。焦虑和抑郁并不常见（2,1.6％）。
结论：CP患者的身体和心理社会生活质量受损。疼痛的存在和较低的SES对生活质量产生不利影响。精神病合并症并不常见。
