Long-term Outcomes in Sinus Surgery Using New Tools for Measuring Health-Related Quality of Life

Abstract

Objectives:

Compare pre- and post-operative outcomes at 3 and 12 months using both disease specific (SNOT-22, Chronic Sinusitis Survey) and general health related quality of life (EQ-5D) assessments. Describe baseline Health utility values (HUV) in patients with chronic rhinosinusitis, and calculate the impact of sinus surgery on the HUV at 3 and 12 months.

Methods:

From February 2011-2013, prospective pre- and postoperative quality of life data were obtained from patients with chronic rhinosinusitis at Massachusetts Eye and Ear Infirmary. Data obtained pre-operatively were compared to post-operative results at 3 and 12 months.

Results:

480 patients enrolled in the study. Three and twelve month response rates have been 73% and 69%, respectively. Patient scores on the SNOT-22 significantly improved from 48.4 +/- 22.0 preoperatively to 22.8 +/- 20.3 at 3 months, 95% confidence interval (CI) [22.5, 28.6], and 25.9 +/- 20.0 at 12 months, 95% CI [18.8, 26.3]. Patient scores on the CSS similarly fell at 3 and 12 months, with statistically and clinically significant improvement. Baseline health utility values in our population scored at 0.81 +/- 0.13, where 0 is a quality of life equal to death and 1 is perfect health. Health utility values improved to 0.89 +/-0.12, 95% CI [-0.10, -0.06], at 3 months and remained unchanged at 12 months.

Conclusions:

Long term disease specific and general health related quality of life are significantly improved after endoscopic sinus surgery. Defining changes in health utility values after sinus surgery represents an important first step in meaningful comparative quality of life research.