Phone: +49 30 450 529 038 Address: Charité - Universitätsmedizin Berlin
Institute for Social Medicine, Epidemiology and Health Economics
Epidemiology and Prevention Research Unit
Luisenstr. 57, 10117 Berlin, Germany
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, Jan 2, 2015
We read with interest the letter of Kawada concerning the assessment of sleep in children with at... more We read with interest the letter of Kawada concerning the assessment of sleep in children with atopic dermatitis (1) in reply to our manuscript (2) focusing on improved management of childhood atopic dermatitis after individually tailored nurse consultations. Our work focussed on a better implementation of care recommendations within the families. We agree that sleep with respect to symptom control and quality of life of patients with atopic dermatitis and their families is an important topic. However, we disagree to Kawada's concern, that our measurement was inappropriate. This article is protected by copyright. All rights reserved.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, Jan 23, 2015
For optimal therapy of atopic dermatitis (AD) in children, parent education for treatment strateg... more For optimal therapy of atopic dermatitis (AD) in children, parent education for treatment strategies that consider the episodic course and multiple triggers is essential. Regular consultations with doctors often cannot appropriately provide this. Therefore, supplemental patient education tools have been established. We evaluate single nurse consultations, assessing their global benefit, parents' self-confidence, and children's symptoms and sleep disturbance. Parents of children with AD were invited for an individually tailored nurse consultation by the doctor initially consulted in cases where difficulties in implementing care recommendations were detected and established therapeutic patient education (TPE) group programmes were impracticable. Parents' estimation of their own self-confidence, current disease severity and its treatment was assessed by a questionnaire at the consultation and by telephone 14 days later. Parents of 1628 children (mean age 1.7 yr) attended co...
The University, duly authorized by the authors or their legal representatives, herewith authorize... more The University, duly authorized by the authors or their legal representatives, herewith authorizes the User, in accordance with the principles of the "Budapest Open Access Initiative"(BOAI, 2002), to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. ... The present licence does not authorize the use of the ...
The occurrence of allergic multimorbidity (coexistence of asthma, allergic rhinitis and eczema) h... more The occurrence of allergic multimorbidity (coexistence of asthma, allergic rhinitis and eczema) has not been evaluated longitudinally from early childhood up to adulthood in a population-based study sample. We aimed to determine the prevalence of allergic multimorbidity up to age 20 stratified by parental allergies and sex/gender using extensive prospective follow-up data from two decades of a birth cohort study. In 1990, we recruited 1314 healthy newborns from 6 maternity wards across Germany for the population-based MAS birth cohort study. The sample was purposely risk-enriched by increasing the proportion of children at high allergy-risk (i.e. at least 2 allergic family members among parents and siblings) from 19% in the source population to 38% in the final sample. The remaining 62% of all MAS children had a low or no allergy risk. Symptoms, medication and doctor's diagnoses of allergic diseases have been assessed using standardised questionnaires including validated ISAAC questions in 19 follow-up assessments up to age 20. Allergic multimorbidity at each time point was defined as the coexistence of at least 2 of the following diseases in one participant: asthma, allergic rhinitis, eczema. Response at age 20 was 72% (n=942) of all recruited participants. At age 20, 18.5% (95%-CI 15.0-22.5%) of all participants with allergic parents had 2 or 3 concurrent allergies as compared to only 6.3% (95%-CI 4.3-9.0%) of those with non-allergic parents. At this age, allergic multimorbidity was similar in females and males (12.7% (95%-CI 9.7-16.2%) vs. 11.6% (95%-CI 8.9-14.8%)); whereas single allergic diseases were more common in women than men (24.2% (95%-CI 20.2-28.5%) vs. 20.1% (95%-CI 16.6-24.0%)). Asthma occurred more frequently with coexisting allergic rhinitis and/or eczema than as a single entity from pre-puberty to adulthood. Having parents with allergies is not only a strong predictor to develop any allergy but it strongly increases the risk of developing allergic multimorbidity. In males and females alike, co-existing allergies were increasingly common throughout adolescence up to adulthood. Particularly asthma occurred in both sexes more frequently with co-existing allergies than as a single entity. This article is protected by copyright. All rights reserved.
A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at ag... more A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at age 8 years based on 10 predictors assessed in early childhood, including current respiratory symptoms, eczema, and parental history of asthma. We aimed to externally validate the proposed asthma prediction method in a German birth cohort. The MAS-90 study (Multicentre Allergy Study) recorded details on allergic diseases prospectively in about yearly follow-up assessments up to age 20 years in a cohort of 1,314 children born 1990. We replicated the scoring method from the Leicester cohort and assessed prediction, performance and discrimination. The primary outcome was defined as the combination of parent-reported wheeze and asthma drugs (both in last 12 months) at age 8. Sensitivity analyses assessed model performance for outcomes related to asthma up to age 20 years. For 140 children parents reported current wheeze or cough at age 3 years. Score distribution and frequencies of later asthma resembled the Leicester cohort: 9% vs. 16% (MAS-90 vs. Leicester) of children at low risk at 3 years had asthma at 8 years, at medium risk 45% vs. 48%. Performance of the asthma prediction tool in the MAS-90 cohort was similar (Brier score 0.22 vs. 0.23) and discrimination slightly better than in the original cohort (area under the curve, AUC 0.83 vs. 0.78). Prediction and discrimination were robust against changes of inclusion criteria, scoring and outcome definitions. The secondary outcome 'physicians' diagnosed asthma at 20 years' showed the highest discrimination (AUC 0.89). The novel asthma prediction tool from the Leicester cohort, UK, performed well in another population, a German birth cohort, supporting its use and further development as a simple aid to predict asthma risk in clinical settings.
The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prev... more The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prevention strategies. We aimed to determine early-life predictors of asthma incidence up to age 20 years in a birth cohort study by applying time-to-event analysis. In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated from birth to age 20 years at 19 time points. Using a Cox regression model, we examined the associations between 36 early-life factors and onset of asthma based on a doctor's diagnosis or asthma medication (primary outcome), typical asthma symptoms, or allergic asthma (including positive IgE measurements). Response at 20 years was 71.6%. Two hundred eighteen subjects met the primary outcome criteria within 16,257 person years observed. Asthma incidence was lower in participants who were vaccinated (measles, mumps, and rubella vaccine/tick-borne encephalitis vaccine/BCG vaccine: adjusted hazard ratio [HR], 0.66 [95% CI, 0.47-0.93]). Up to age 20 years, asthma incidence was higher in subjects who had parents with allergic rhinitis (adjusted HR, 2.24 [95% CI, 1.67-3.02]), started day care early or late (before 18 months: adjusted HR, 1.79 [95% CI, 1.03-3.10]; after 3 years: adjusted HR, 1.64 [95% CI, 0.96-2.79]), had mothers who smoked during pregnancy (adjusted HR, 1.79 [95% CI, 1.20-2.67]), had poor parents (adjusted HR, 1.55 [95% CI, 1.09-2.22]), and had parents with asthma (adjusted HR, 1.65 [95% CI, 1.17-2.31]). Not associated with asthma were aspects of diet and breast-feeding, pet ownership, presence of older siblings, and passive smoking. Parental asthma and nasal allergy increase asthma incidence in offspring up to adulthood. Avoiding tobacco smoke exposure during pregnancy, receiving vaccinations in early childhood, and starting day care between 1.5 and 3 years of age might prevent or delay the development of asthma.
International Archives of Allergy and Immunology, 2009
Exposure and sensitization to pet allergens are associated with allergic asthma in children. Conf... more Exposure and sensitization to pet allergens are associated with allergic asthma in children. Conflicting data have emerged regarding the potential benefit of air cleaners with respect to a reduction of indoor pet allergens and bronchial hyperresponsiveness (BHR).
Background and purpose: Educating the public to screen for vascular risk factors and have them t... more Background and purpose: Educating the public to screen for vascular risk factors and have them treated is a major public health issue. We assessed the vascular risk factor awareness and frequency of treatment in a cohort of patients with cerebral ischaemia.Methods: Data on awareness and pharmacological treatment of vascular risk factors before hospital admission of patients with confirmed ischaemic stroke/transient ischaemic attack (TIA) were analyzed. A follow-up questionnaire assessed the frequency of treatment 1 year after discharge and assessed non-adherence to antithrombotic medication.Results: At time of stroke/TIA, individual awareness regarding existing hypertension, diabetes, hyperlipidemia and atrial fibrillation (AF) was 83%, 87%, 73% and 69% respectively (n = 558). Pharmacological treatment for hypertension, diabetes, hyperlipidemia and AF was being administered in 80%, 77%, 37% and 62% of patients aware of their conditions. The follow-up was completed by 383 patients (80% recall rate): of the patients with hypertension, diabetes, hyperlipidemia and AF, 89%, 78%, 45% and 86% were receiving risk factor targeted medication. This represents a significant increase concerning AF and hyperlipidemia. Non-adherence to recommended antithrombotics (15%) was higher in patients who had had a TIA.Conclusions: All risk factors leave room for improvement in screening and treatment efforts. Adherence to treatment is higher for hypertension and diabetes than for hyperlipidemia. Education efforts should bear in mind less well recognized risk factors.
Hintergrund Ob sich klinische Symptome von transitorisch ischämischer Attacke (TIA) und Schlaganf... more Hintergrund Ob sich klinische Symptome von transitorisch ischämischer Attacke (TIA) und Schlaganfall abgesehen vom zeitlichen Verlauf unterscheiden, ist unklar. Methoden Anamnestische Beschwerden und klinische Symptome von Patienten mit TIA und Schlaganfall wurden prospektiv erfasst und anhand einer altersadjustierten, logistischen Regression verglichen. Risikofaktoren, Medikamenteneinnahme und Diagnostik gingen in die vergleichende Analyse ein. Ergebnisse 405 Schlaganfallpatienten (68±12 Jahre, 45% weiblich) und 143 TIA-Patienten (64±14 Jahre, 48% weiblich) wurden einbezogen. Sowohl als anamnestische Beschwerde, als auch im klinischen Befund hatten TIA-Patienten signifikant seltener „klassische“ Symptome wie Parese (48% vs. 71%, p p=0,03). Die Ätiologie der TIA wurde häufiger der Kategorie „ungeklärt“ zugeordnet (57% vs. 46%, p Schlussfolgerungen Da die TIA mit einem erheblichen Risiko für Tod und Behinderung verbunden ist, aber seltener mit „klassischen“ Symptomen auftritt und seltener ätiologisch zugeordnet werden kann, erfordert sie eine besondere Aufmerksamkeit und intensive Diagnostik. Background It is unclear whether clinical signs and symptoms differ in the presentation of transient ischemic attack (TIA) and stroke, apart from temporal dynamics. Methods Signs and symptoms of patients diagnosed with TIA or stroke were prospectively collected and compared by means of an age-adjusted logistic regression analysis. Risk factors, prehospital medication, and diagnostic workup were obtained from the charts. Results Four hundred five patients diagnosed with stroke (68±12 years old, 45% female) and 143 diagnosed with TIA (64±14 years old, 48% female) were included. Signs and symptoms of patients with TIA were less often “classic” such as paresis (48% vs 71%, PP=0.03). The etiology of TIA was more often classified as “undetermined” (57% vs 46%, P Conclusions Transient ischemic attack needs special attention and intensive diagnostic workup, because it bears a considerable risk of death and disability but presents less often with classic signs and symptoms and its etiology often remains undetermined.
Pancreatic cancer is an aggressive cancer with low survival time, with health-related quality of ... more Pancreatic cancer is an aggressive cancer with low survival time, with health-related quality of life (HRQoL) being of major importance. The aim of our study was to assess both generic and disease-specific HRQoL in patients with pancreatic cancer. Patients with pancreatic cancer were consecutively included at admission to hospital. HRQoL was determined with the disease-specific European Organization for Research and Treatment of Cancer (EORTC) and generic EuroQoL (EQ-5D) health status instruments. Scores of patients were compared to those of norm populations. The association of symptoms with overall HRQoL was analysed using linear regression. A total of 45 patients with pancreatic cancer were included. The mean age was 64 years, 53% were females. Of all patients, 44% had metastases at the time of admission. HRQoL was significantly impaired for most EORTC and EQ-5D scales in comparison to norm populations. Symptoms of fatigue (-0.34 regression coefficient; 95% CI -0.63, -0.11) and pain (-0.21; 95% CI -0.39, -0.02) were significantly associated with impaired overall HRQoL. HRQoL was severely impaired in patients with pancreatic cancer. Symptom control and palliative care appear to be of particular importance.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, Jan 2, 2015
We read with interest the letter of Kawada concerning the assessment of sleep in children with at... more We read with interest the letter of Kawada concerning the assessment of sleep in children with atopic dermatitis (1) in reply to our manuscript (2) focusing on improved management of childhood atopic dermatitis after individually tailored nurse consultations. Our work focussed on a better implementation of care recommendations within the families. We agree that sleep with respect to symptom control and quality of life of patients with atopic dermatitis and their families is an important topic. However, we disagree to Kawada's concern, that our measurement was inappropriate. This article is protected by copyright. All rights reserved.
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, Jan 23, 2015
For optimal therapy of atopic dermatitis (AD) in children, parent education for treatment strateg... more For optimal therapy of atopic dermatitis (AD) in children, parent education for treatment strategies that consider the episodic course and multiple triggers is essential. Regular consultations with doctors often cannot appropriately provide this. Therefore, supplemental patient education tools have been established. We evaluate single nurse consultations, assessing their global benefit, parents' self-confidence, and children's symptoms and sleep disturbance. Parents of children with AD were invited for an individually tailored nurse consultation by the doctor initially consulted in cases where difficulties in implementing care recommendations were detected and established therapeutic patient education (TPE) group programmes were impracticable. Parents' estimation of their own self-confidence, current disease severity and its treatment was assessed by a questionnaire at the consultation and by telephone 14 days later. Parents of 1628 children (mean age 1.7 yr) attended co...
The University, duly authorized by the authors or their legal representatives, herewith authorize... more The University, duly authorized by the authors or their legal representatives, herewith authorizes the User, in accordance with the principles of the "Budapest Open Access Initiative"(BOAI, 2002), to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. ... The present licence does not authorize the use of the ...
The occurrence of allergic multimorbidity (coexistence of asthma, allergic rhinitis and eczema) h... more The occurrence of allergic multimorbidity (coexistence of asthma, allergic rhinitis and eczema) has not been evaluated longitudinally from early childhood up to adulthood in a population-based study sample. We aimed to determine the prevalence of allergic multimorbidity up to age 20 stratified by parental allergies and sex/gender using extensive prospective follow-up data from two decades of a birth cohort study. In 1990, we recruited 1314 healthy newborns from 6 maternity wards across Germany for the population-based MAS birth cohort study. The sample was purposely risk-enriched by increasing the proportion of children at high allergy-risk (i.e. at least 2 allergic family members among parents and siblings) from 19% in the source population to 38% in the final sample. The remaining 62% of all MAS children had a low or no allergy risk. Symptoms, medication and doctor's diagnoses of allergic diseases have been assessed using standardised questionnaires including validated ISAAC questions in 19 follow-up assessments up to age 20. Allergic multimorbidity at each time point was defined as the coexistence of at least 2 of the following diseases in one participant: asthma, allergic rhinitis, eczema. Response at age 20 was 72% (n=942) of all recruited participants. At age 20, 18.5% (95%-CI 15.0-22.5%) of all participants with allergic parents had 2 or 3 concurrent allergies as compared to only 6.3% (95%-CI 4.3-9.0%) of those with non-allergic parents. At this age, allergic multimorbidity was similar in females and males (12.7% (95%-CI 9.7-16.2%) vs. 11.6% (95%-CI 8.9-14.8%)); whereas single allergic diseases were more common in women than men (24.2% (95%-CI 20.2-28.5%) vs. 20.1% (95%-CI 16.6-24.0%)). Asthma occurred more frequently with coexisting allergic rhinitis and/or eczema than as a single entity from pre-puberty to adulthood. Having parents with allergies is not only a strong predictor to develop any allergy but it strongly increases the risk of developing allergic multimorbidity. In males and females alike, co-existing allergies were increasingly common throughout adolescence up to adulthood. Particularly asthma occurred in both sexes more frequently with co-existing allergies than as a single entity. This article is protected by copyright. All rights reserved.
A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at ag... more A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at age 8 years based on 10 predictors assessed in early childhood, including current respiratory symptoms, eczema, and parental history of asthma. We aimed to externally validate the proposed asthma prediction method in a German birth cohort. The MAS-90 study (Multicentre Allergy Study) recorded details on allergic diseases prospectively in about yearly follow-up assessments up to age 20 years in a cohort of 1,314 children born 1990. We replicated the scoring method from the Leicester cohort and assessed prediction, performance and discrimination. The primary outcome was defined as the combination of parent-reported wheeze and asthma drugs (both in last 12 months) at age 8. Sensitivity analyses assessed model performance for outcomes related to asthma up to age 20 years. For 140 children parents reported current wheeze or cough at age 3 years. Score distribution and frequencies of later asthma resembled the Leicester cohort: 9% vs. 16% (MAS-90 vs. Leicester) of children at low risk at 3 years had asthma at 8 years, at medium risk 45% vs. 48%. Performance of the asthma prediction tool in the MAS-90 cohort was similar (Brier score 0.22 vs. 0.23) and discrimination slightly better than in the original cohort (area under the curve, AUC 0.83 vs. 0.78). Prediction and discrimination were robust against changes of inclusion criteria, scoring and outcome definitions. The secondary outcome 'physicians' diagnosed asthma at 20 years' showed the highest discrimination (AUC 0.89). The novel asthma prediction tool from the Leicester cohort, UK, performed well in another population, a German birth cohort, supporting its use and further development as a simple aid to predict asthma risk in clinical settings.
The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prev... more The lack of longitudinal data analyses from birth to adulthood is hampering long-term asthma prevention strategies. We aimed to determine early-life predictors of asthma incidence up to age 20 years in a birth cohort study by applying time-to-event analysis. In 1990, the Multicenter Allergy Study included 1314 newborns in 5 German cities. Children were evaluated from birth to age 20 years at 19 time points. Using a Cox regression model, we examined the associations between 36 early-life factors and onset of asthma based on a doctor's diagnosis or asthma medication (primary outcome), typical asthma symptoms, or allergic asthma (including positive IgE measurements). Response at 20 years was 71.6%. Two hundred eighteen subjects met the primary outcome criteria within 16,257 person years observed. Asthma incidence was lower in participants who were vaccinated (measles, mumps, and rubella vaccine/tick-borne encephalitis vaccine/BCG vaccine: adjusted hazard ratio [HR], 0.66 [95% CI, 0.47-0.93]). Up to age 20 years, asthma incidence was higher in subjects who had parents with allergic rhinitis (adjusted HR, 2.24 [95% CI, 1.67-3.02]), started day care early or late (before 18 months: adjusted HR, 1.79 [95% CI, 1.03-3.10]; after 3 years: adjusted HR, 1.64 [95% CI, 0.96-2.79]), had mothers who smoked during pregnancy (adjusted HR, 1.79 [95% CI, 1.20-2.67]), had poor parents (adjusted HR, 1.55 [95% CI, 1.09-2.22]), and had parents with asthma (adjusted HR, 1.65 [95% CI, 1.17-2.31]). Not associated with asthma were aspects of diet and breast-feeding, pet ownership, presence of older siblings, and passive smoking. Parental asthma and nasal allergy increase asthma incidence in offspring up to adulthood. Avoiding tobacco smoke exposure during pregnancy, receiving vaccinations in early childhood, and starting day care between 1.5 and 3 years of age might prevent or delay the development of asthma.
International Archives of Allergy and Immunology, 2009
Exposure and sensitization to pet allergens are associated with allergic asthma in children. Conf... more Exposure and sensitization to pet allergens are associated with allergic asthma in children. Conflicting data have emerged regarding the potential benefit of air cleaners with respect to a reduction of indoor pet allergens and bronchial hyperresponsiveness (BHR).
Background and purpose: Educating the public to screen for vascular risk factors and have them t... more Background and purpose: Educating the public to screen for vascular risk factors and have them treated is a major public health issue. We assessed the vascular risk factor awareness and frequency of treatment in a cohort of patients with cerebral ischaemia.Methods: Data on awareness and pharmacological treatment of vascular risk factors before hospital admission of patients with confirmed ischaemic stroke/transient ischaemic attack (TIA) were analyzed. A follow-up questionnaire assessed the frequency of treatment 1 year after discharge and assessed non-adherence to antithrombotic medication.Results: At time of stroke/TIA, individual awareness regarding existing hypertension, diabetes, hyperlipidemia and atrial fibrillation (AF) was 83%, 87%, 73% and 69% respectively (n = 558). Pharmacological treatment for hypertension, diabetes, hyperlipidemia and AF was being administered in 80%, 77%, 37% and 62% of patients aware of their conditions. The follow-up was completed by 383 patients (80% recall rate): of the patients with hypertension, diabetes, hyperlipidemia and AF, 89%, 78%, 45% and 86% were receiving risk factor targeted medication. This represents a significant increase concerning AF and hyperlipidemia. Non-adherence to recommended antithrombotics (15%) was higher in patients who had had a TIA.Conclusions: All risk factors leave room for improvement in screening and treatment efforts. Adherence to treatment is higher for hypertension and diabetes than for hyperlipidemia. Education efforts should bear in mind less well recognized risk factors.
Hintergrund Ob sich klinische Symptome von transitorisch ischämischer Attacke (TIA) und Schlaganf... more Hintergrund Ob sich klinische Symptome von transitorisch ischämischer Attacke (TIA) und Schlaganfall abgesehen vom zeitlichen Verlauf unterscheiden, ist unklar. Methoden Anamnestische Beschwerden und klinische Symptome von Patienten mit TIA und Schlaganfall wurden prospektiv erfasst und anhand einer altersadjustierten, logistischen Regression verglichen. Risikofaktoren, Medikamenteneinnahme und Diagnostik gingen in die vergleichende Analyse ein. Ergebnisse 405 Schlaganfallpatienten (68±12 Jahre, 45% weiblich) und 143 TIA-Patienten (64±14 Jahre, 48% weiblich) wurden einbezogen. Sowohl als anamnestische Beschwerde, als auch im klinischen Befund hatten TIA-Patienten signifikant seltener „klassische“ Symptome wie Parese (48% vs. 71%, p p=0,03). Die Ätiologie der TIA wurde häufiger der Kategorie „ungeklärt“ zugeordnet (57% vs. 46%, p Schlussfolgerungen Da die TIA mit einem erheblichen Risiko für Tod und Behinderung verbunden ist, aber seltener mit „klassischen“ Symptomen auftritt und seltener ätiologisch zugeordnet werden kann, erfordert sie eine besondere Aufmerksamkeit und intensive Diagnostik. Background It is unclear whether clinical signs and symptoms differ in the presentation of transient ischemic attack (TIA) and stroke, apart from temporal dynamics. Methods Signs and symptoms of patients diagnosed with TIA or stroke were prospectively collected and compared by means of an age-adjusted logistic regression analysis. Risk factors, prehospital medication, and diagnostic workup were obtained from the charts. Results Four hundred five patients diagnosed with stroke (68±12 years old, 45% female) and 143 diagnosed with TIA (64±14 years old, 48% female) were included. Signs and symptoms of patients with TIA were less often “classic” such as paresis (48% vs 71%, PP=0.03). The etiology of TIA was more often classified as “undetermined” (57% vs 46%, P Conclusions Transient ischemic attack needs special attention and intensive diagnostic workup, because it bears a considerable risk of death and disability but presents less often with classic signs and symptoms and its etiology often remains undetermined.
Pancreatic cancer is an aggressive cancer with low survival time, with health-related quality of ... more Pancreatic cancer is an aggressive cancer with low survival time, with health-related quality of life (HRQoL) being of major importance. The aim of our study was to assess both generic and disease-specific HRQoL in patients with pancreatic cancer. Patients with pancreatic cancer were consecutively included at admission to hospital. HRQoL was determined with the disease-specific European Organization for Research and Treatment of Cancer (EORTC) and generic EuroQoL (EQ-5D) health status instruments. Scores of patients were compared to those of norm populations. The association of symptoms with overall HRQoL was analysed using linear regression. A total of 45 patients with pancreatic cancer were included. The mean age was 64 years, 53% were females. Of all patients, 44% had metastases at the time of admission. HRQoL was significantly impaired for most EORTC and EQ-5D scales in comparison to norm populations. Symptoms of fatigue (-0.34 regression coefficient; 95% CI -0.63, -0.11) and pain (-0.21; 95% CI -0.39, -0.02) were significantly associated with impaired overall HRQoL. HRQoL was severely impaired in patients with pancreatic cancer. Symptom control and palliative care appear to be of particular importance.
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