Pancreatic necrosis: Assessment of outcome related to quality of life and cost of management

Abstract

Ten patients with necrotizing pancreatitis admitted consecutively between August 1990 and August 1991 were studied. They comprised eight men and two women of median age 63 (range 29-73) years. One patient died. The median length of hospital stay was 74 (range 40-150) days. The median number of operations and endoscopic procedures performed per patient was 4 (range 2-7). Investigations performed included multiple bacteriological, radiological, haematological and biochemical tests. The mean cost of management was 18,441 pounds (range 9,296 pounds-33,796 pounds), of which hospitalization accounted for 65 per cent, operations and endoscopic procedures 20 per cent and investigations 16 per cent. Cost-utility analysis demonstrated a mean benefit per patient of 8.55 quality-adjusted life years gained at a cost of 2,157 pounds each. The management of pancreatic necrosis is expensive but justified by the excellent outcome in terms of quality of life.

Pancreatic diseases

“…Consequently, the mean length of stay in hospital is longer and has been reported to be as high as 74 days. 30 The financial burden on institutions is substantial. The cost of treating a patient in intensive care has been calculated to be £1500 per day.…”

“…The mean cost has been estimated at £18 441. 30 When including quality of life measurements, the total cost of caring for such cases has been calculated to be £2157 per quality-adjusted year of life, with a mean of 8.6 years gained. The long-term outcome for the majority of patients who undergo treatment is good.…”

Pancreatic Diseases: The Need to Assess the Quality of Life Raffaele Pezzilli

“…All these studies regard patients operated on for acute illness and, in the majority of them, the patient's reported outcomes were evaluated only after a long time interval following discharge [3][4][5][6][7][8]. The questionnaires used in these six studies were: the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) in four [4,5,7,8], the Rosser disability and distress index in one [3], and the Karnofsky score, the Rankin score and the Sickness Impact Profile in the remaining one [6]. In one study, the patients completed the questionnaire after 1 year [3], whereas, in the other studies, the questionnaires were completed within 3 years after discharge [4][5][6][7][8].…”

“…The questionnaires used in these six studies were: the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) in four [4,5,7,8], the Rosser disability and distress index in one [3], and the Karnofsky score, the Rankin score and the Sickness Impact Profile in the remaining one [6]. In one study, the patients completed the questionnaire after 1 year [3], whereas, in the other studies, the questionnaires were completed within 3 years after discharge [4][5][6][7][8]. While the majority of authors have reported a good quality of life for their patients cured of acute pancreatitis [3][4][5][6][7], others have not [8].…”

“…In one study, the patients completed the questionnaire after 1 year [3], whereas, in the other studies, the questionnaires were completed within 3 years after discharge [4][5][6][7][8]. While the majority of authors have reported a good quality of life for their patients cured of acute pancreatitis [3][4][5][6][7], others have not [8]. Finally, there are no data available on the modification of the patient's reported outcome in medically-treated patients.…”