Predictive factors of a beneficial quality of life outcome in patients undergoing primary sinonasal surgery: a population-based prospective cohort study

被引:11
作者
Alakarppa, Antti I. [1 ,2 ]
Koskenkorva, Timo J. [1 ,2 ]
Koivunen, Petri T. [1 ,2 ]
Alho, Olli-Pekka [1 ,2 ]
机构
[1] Oulu Univ Hosp, Dept Otorhinolaryngol & Head & Neck Surg, OYS, POB 21, Oulu 90029, Finland
[2] Univ Oulu, PEDEGO Res Unit, Oulu, Finland
基金
英国科研创新办公室;
关键词
Septoplasty; Endoscopic sinus surgery; Quality of life; Septal deviation; Chronic rhinosinusitis; Sinonasal surgery; ENDOSCOPIC SINUS SURGERY; CHRONIC RHINOSINUSITIS; SEPTOPLASTY; VALIDITY; SNOT-22; TEST-22;
D O I
10.1007/s00405-018-4918-3
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
To assess predictive factors of a beneficial quality of life (QoL) outcome after primary sinonasal surgery. A population-based prospective cohort study among 160 adult patients undergoing primary sinonasal surgery (76 septoplasties, SP; 84 endoscopic sinus surgeries, ESS) was conducted. We collected QoL data using the Sinonasal Outcome Test-22 (SNOT-22) before and after surgery. A beneficial QoL outcome was defined as a SNOT-22 score change ae<yen> 9 points 12 months after surgery. Various demographic, clinical and symptom-related factors predicting a beneficial QoL outcome were sought using binary logistic regression analysis. The mean age of the patients was 39 years (range 18-61) and 82 (51%) were males. The SNOT-22 score change varied markedly after SP (range - 17 to + 80) and ESS (range - 20 to + 58), but on average it improved (median + 15 after SP and + 16 after ESS). 41 patients (64%) achieved beneficial QoL outcome after SP and 46 (66%) after ESS. In a multivariate analysis, poor QoL before surgery (preoperative SNOT-22 ae<yen> 20 points) predicted a beneficial QoL outcome after SP and ESS (adjusted odds ratio 10; 95% confidence interval 1.6-64 and 12; 2.5-55, respectively) and a senior surgeon operating after SP (9.9; 1.5-67). On receiver operating characteristic curve analysis, the integer threshold value for the preoperative SNOT-22 score that gave the highest sensitivity (74%) and specificity (70%) was 30. QoL change after primary SP and ESS varies. A preoperative SNOT-22 score of at least 30 best predicted a beneficial QoL outcome after both procedures.
引用
收藏
页码:1139 / 1147
页数:9
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