Tu2037 EMPLOYMENT STATUS AND HOSPITAL ADMISSIONS AS POTENTIAL MEASURES OF QUALITY OF LIFE FOR PATIENTS UNDERGOING TOTAL PANCREATECTOMY AND ISLET AUTOTRANSPLANTATION

2020 ◽  
Vol 158 (6) ◽  
pp. S-1596
Author(s):  
Jill Buss ◽  
Luis F. Lara ◽  
Amer Rajab ◽  
Phil A. Hart ◽  
Shumei Meng ◽  
...  
2016 ◽  
Vol 14 (9) ◽  
pp. 1317-1323 ◽  
Author(s):  
Melena D. Bellin ◽  
Tossapol Kerdsirichairat ◽  
Gregory J. Beilman ◽  
Ty B. Dunn ◽  
Srinath Chinnakotla ◽  
...  

2013 ◽  
Vol 79 (7) ◽  
pp. 676-680 ◽  
Author(s):  
Margaret Dorlon ◽  
Stephanie Owczarski ◽  
Hongjun Wang ◽  
David Adams ◽  
Katherine Morgan

Previous studies have shown that total pancreatectomy with islet cell autotransplantation improves quality of life in chronic pancreatitis. A significant number of these patients develop postoperative hyperglycemia and daily insulin requirements or increase in daily insulin requirements. Our study investigates whether increased insulin requirements postoperatively have a negative impact on quality of life. A prospectively collected database of 74 patients undergoing extensive pancreatectomy with islet autotransplantation for pancreatitis was reviewed. Data pertaining to daily requirements and quality of life (QOL), as measured by the SF-12 questionnaire, in the preoperative and postoperative period were reviewed. Approval from the Institutional Review Board for the evaluation of human subjects was obtained. Seventy-four patients underwent extensive pancreatectomy with islet autotransplantation for pancreatitis. The majority of these patients required new daily insulin or an increase in daily insulin requirements post-operatively. Mean preoperative HA1c in this group was 5.6 with an increase to 7.3 at 6 months postoperatively ( P < 0.001), a mean of 8.1 at 12 months, and 8.9 at 2 years. Mean preoperative daily insulin requirements for this group were five units/day with average increase to 19 units/day at 6 months, 21 units/day at 12 months, and 26 units/day at 2 years. Preoperative QOL scores were a mean of 26 for the physical component and 36 for the mental health component. Postoperatively, physical component scores averaged 33 at 6 months (p < 0.001), 36 at 12 months, and 36 at 2 years; the mental health component scores averaged 42 at 6 months (p = 0.007), 41 at 12 months, and 41 at 2 years. There is no correlation between physical component score or mental component score QOL scores and daily insulin requirements ( r = -0.016 and r = 0.039, respectively). Total pancreatectomy with islet cell autotransplantation is an effective surgery for end-stage chronic pancreatitis. Quality of life significantly improves in physical and mental health components regardless of a postoperative increase in daily insulin requirements.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 120-OR
Author(s):  
JACOB M. REDEL ◽  
LINDSEY HORNUNG ◽  
DEBORAH A. ELDER ◽  
JAIMIE D. NATHAN ◽  
MAISAM ABU-EL-HAIJA

2020 ◽  
Vol 158 (6) ◽  
pp. S-1530-S-1531
Author(s):  
Michael E. Johnston ◽  
Al-Faraaz Kassam ◽  
Alexander R. Cortez ◽  
Tom K. Lin ◽  
Maisam Abu-El-Haija ◽  
...  

2021 ◽  
Author(s):  
Clarence Aaron Cheng Sy

Abstract Background: Though found to be a common occurrence in individuals caring for patients with debilitating illnesses such as cancer, caregiver burden remains underprioritized, and its relationship with patient outcomes is only sparingly described. Methodology: This cross-sectional, observational study included 50 patient-caregiver pairs receiving anti-cancer systemic therapy at a tertiary hospital in Cebu City. Sociodemographic and clinical characteristics were obtained. Patient quality of life was measured using the EQ-5D-5L Questionnaire, while caregiver burden was assessed with the Zarit Burden Interview. The association between caregiver burden and patient outcomes were examined using multivariate logistic regression models and bivariate analysis.Results: Patients included in the study were predominantly females, middle-aged to elderly, and in advanced stages of disease, whereas caregivers were mostly female, and younger in relation. The usual patient-caregiver relationships were spousal and parental. Educational attainment, employment status and income varied among caregivers, and were significantly associated with caregiver burden, as were patient age, a lung primary, and limitations in patient mobility, self-care and ability to perform usual activities. On the other hand, higher levels of caregiver burden were linked to quality of life impairment, increased anxiety or depression, and more frequent hospital admissions for patients.Discussion: The level of care in patients requiring continuous assistance often leads to an imbalance of care demands relative to the caregiver’s personal time and space, roles and resources, the latter being particularly relevant in the third-world setting where healthcare expenditure remains largely out-of-pocket. Patients likewise suffer from the burden they unwillingly impose on caregivers, with self-perceived burden contributing significantly to patient anxiety and depression, and influencing therapeutic choices in the direction of palliative care over curative therapy. Additionally, a higher level of caregiver burden was found to compromise the quality of care, and increase reliance on health systems, often leading to more frequent hospital admissions, perpetuating a vicious cycle of demand and burden.Conclusions: Financial standing, which can be influenced by educational attainment, employment status and income, was found to be significantly associated with caregiver burden. Patient-related factors such as age, a lung primary, and assistance requirement were also associated factors. Conversely, caregiver burden was found to influence patient quality of life via the impairment of mobility, self-care and ability to perform activities of daily living, and an increase in anxiety or depression. Higher levels of caregiver burden were also found to be associated with a higher frequency of hospital admissions for the patient.


2014 ◽  
Vol 146 (5) ◽  
pp. S-1090
Author(s):  
Katherine A. Morgan ◽  
Stefanie M. Owczarski ◽  
Jeffrey J. Borckardt ◽  
Wendy Balliet ◽  
Hongjun Wang ◽  
...  

2012 ◽  
Vol 78 (8) ◽  
pp. 893-896 ◽  
Author(s):  
Katherine A. Morgan ◽  
Tom Theruvath ◽  
Stefanie Owczarski ◽  
David B. Adams

Total pancreatectomy with immediate islet autotransplantation (IAT) can be an effective therapy in patients with chronic pancreatitis. Patient selection criteria for radical resection are not well defined. The impact of prior pancreatic surgery on quality of life outcomes in patients undergoing IAT is evaluated. A retrospective review of a prospectively collected database of patients undergoing pancreatectomy with islet autotransplantation was undertaken. Patients having undergone prior pancreatic resection and/or drainage procedures were compared with those without prior pancreatic operative history. Sixty-one patients underwent pancreatectomy with IAT for pancreatitis. Twenty-three patients had a prior history of pancreatic surgery (Group S); 38 had no prior history of pancreatic surgery (Group NS). Demographics between the groups were similar. Patients in Group S took more daily oral morphine equivalents and had a lower psychological quality of life preoperatively. Operative times and blood loss were similar between the patient groups. Islet yields were lower for patients in Group S. Postoperatively, daily insulin requirements at 6 months and 1 year trended higher in Group S. Postoperative quality of life scores at 6 months were improved and similar between the groups. Quality of life metrics continued to improve beyond 1 year of follow-up, with a trend toward greater improvement in the NS Group. Total pancreatectomy for chronic pancreatitis improves quality of life in patients with and without a prior history of pancreatic surgery. This study demonstrates that IAT without preceding pancreatic surgery may enhance outcomes measured by long term insulin requirements and quality of life.


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