The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery

被引:23
作者
Ospina, Javier [1 ]
Liu, Guiping [2 ]
Crump, Trafford [3 ]
Sutherland, Jason M. [2 ]
Janjua, Arif [4 ]
机构
[1] Univ British Columbia, Div Otolaryngol Head & Neck Surg, Sinus & Skull Base Surg, Dept Surg,Vancouver Gen Hosp, Vancouver, BC, Canada
[2] Univ British Columbia, Ctr Hlth Serv & Policy Res, Sch Populat & Publ Hlth, Vancouver, BC, Canada
[3] Univ Calgary, Dept Surg, Calgary, AB, Canada
[4] Univ British Columbia, Rhinol Endoscop Sinus & Skull Base Surg, Div Otolaryngol Head & Neck Surg, Dept Surg, Vancouver, BC, Canada
关键词
Chronic rhinosinusitis; Endoscopic sinus surgery; Quality of life; Symptom severity; Patient-reported outcomes; PRIME-MD; SYMPTOMS; VALIDITY; OUTCOMES; UTILITY; SCORE;
D O I
10.1186/s40463-019-0340-0
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
BackgroundDepression and chronic pain are debilitating disorders that co-exist with many chronic diseases. Chronic rhinosinusitis (CRS) is no exception. Nonetheless, little is known about the association between these co-related conditions and the treatment of CRS. The objective of this study is to measure outcomes following endoscopic sinus surgery (ESS) in CRS patients reporting significant pre-operative depression and pain.MethodsThis is a prospective longitudinal cohort study examining patients with CRS who had failed maximal medical therapy and subsequently underwent ESS. Participants completed a several patient-reported outcome (PRO) instruments pre-operatively and 6 months post-operatively. The PROs included the Sinonasal Outcome Test-22 (SNOT-22), the Patient Health Questionnaire (PHQ-9) measuring symptoms of depression and an assessment of chronic pain using the pain intensity (P), interference with enjoyment of life (E) and general (G) activity instrument, the PEG instrument.ResultsThe study had 142 participants complete their pre-operative and post-operative surveys. The participation rate was 40.1% among eligible patients. The prevalence of at least moderate depression was 22 patients (15.5%) among participants. Compared with non-depressed participants, the pre-operative sino-nasal disease burden and pain scores were higher among depressed participants (p<0.001) and the gain in health following surgery was smaller (p<0.001).ConclusionsPre-operative disease burden is higher among depressed patients. Post-operative gains in sino-nasal quality of life attributable to endoscopic sinus surgery were significantly smaller among depressed participants. Pre-operative screening for depression could identify opportunities for medical intervention and improve outcomes among CRS patients.
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页数:7
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