Impact of Age on Sinus Surgery Outcomes

Abstract

Objectives/Hypothesis To evaluate the impact of age on patient‐reported quality of life (QOL) following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Study Design Prospective cohort study. Methods Six hundred thirty‐six patients with CRS were recruited from 11 otolaryngologic practices and completed the sinonasal‐specific, 22‐item Sino‐Nasal Outcome Test‐22 (SNOT‐22) and general health‐related EuroQol 5‐Dimension (EQ‐5D) questionnaires at baseline and 12 and 24 months after ESS. Patients were grouped chronologically to determine whether age at time of ESS was associated with clinical outcomes. Results Ages ranged from 18 to 80 years (mean ± standard deviation = 48.5 ± 14.4). Improvement was observed in postoperative SNOT‐22 scores at 12 and 24 months for all decades of life. Similar improvements were observed for EQ‐5D‐based health utility value (HUV) scores in all decades of life, except for the eldest cohort (ages 70–80, N = 33), who did not exceed the minimal clinically important difference at either 12 or 24 months following ESS. In regression analysis, age was not associated with sinonasal‐specific outcomes (change in SNOT‐22 scores) at 12 (P = .507) or 24 months (P = .955). In general health‐related outcomes, however, age was significantly associated with change in EQ‐5D‐based HUV scores from baseline to 12 months following ESS after adjusting for patient demographics, comorbidities, and surgical history (P = .049). Conclusions This study demonstrates that ESS for adult CRS sufferers offers improved QOL outcomes through the eighth decade of life. The impact of comorbidities on QOL needs to be carefully considered when assessing older patients for sinus surgery. Level of Evidence 2b Laryngoscope, 128:2681–2687, 2018

How Does Age Impact Presentation and Outcomes in Chronic Rhinosinusitis?

“…Several previous studies have demonstrated that ESS offers an efficacious surgical treatment for the elderly patients with CRS. [5][6][7][8][9] Lehmann et al 8 and Yancey et al 9 compared age groups using well validated disease-specific quality of life (QOL) measurement (SNOT-22) and general health-related QOL and health utility value (HUV) instruments. They showed that young adults present with higher preoperative SNOT-22 score.…”

“…The safety and efficacy of ESS for CRS has been well documented by numerous studies in the adult population. [5][6][7][8][9] Older adult patients may have an altered immune response and different morbidity profiles as compared to their younger adult counterparts. 10 Therefore, the severity of CRS at presentation may be different depending on the age of the patient, which in turn may affect treatment outcomes and ultimately subjective symptom scores.…”

Qualität in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen

“…It is a self-assessment of mobility, independence, activities of daily life, pain and anxiety/depression in 3 or 5 levels (EQ-5D-3L or -5L) as well as self-assessment of the health condition on a visual analogue scale. Improvements are found in the HRQoL of patients after sinus surgery in the EQ-5D, in particular in the subunits pain, anxiety/depression and activities of daily life [212,213].…”

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“…Довольно много исследований посвящено функциональному состоянию костной ткани различных локализаций: бедренной кости, поясничного отдела позвоночника [2]. Данные об изменении в губчатой кости стенок околоносовых синусов при физиологических процессах обрывочны, в то время как эта информация необходима для оценки патологических процессов данной локализации в связи со значительным удельным весом воспалительных процессов в ней [3], частотой хронизации этих процессов и неуемно растущим числом ослож нений. Так, к 2060 году прогнозируется двукратное увеличение удельного веса хронических риносинуситов среди пациентов старше 65 лет [3].…”

“…Данные об изменении в губчатой кости стенок околоносовых синусов при физиологических процессах обрывочны, в то время как эта информация необходима для оценки патологических процессов данной локализации в связи со значительным удельным весом воспалительных процессов в ней [3], частотой хронизации этих процессов и неуемно растущим числом ослож нений. Так, к 2060 году прогнозируется двукратное увеличение удельного веса хронических риносинуситов среди пациентов старше 65 лет [3]. Не меньшую угрозу в себе несут и осложнения острых и хронических риносинуситов.…”