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

Journal of Otolaryngology - Head and Neck Surgery

Guiping Liu¹  Jason M. Sutherland¹  Trafford Crump²  Javier Ospina³  Arif Janjua⁴ 

[1] Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia;Department of Surgery, University of Calgary;Division of Otolaryngology - Head and Neck Surgery, Sinus and Skull Base Surgery, Department of Surgery, University of British Columbia, Vancouver General Hospital;Rhinology, Endoscopic Sinus and Skull Base Surgery, Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of British Columbia;

关键词: Chronic rhinosinusitis;    Endoscopic sinus surgery;    Quality of life;    Symptom severity;    Patient-reported outcomes;   

DOI  :  10.1186/s40463-019-0340-0

来源: DOAJ

【 摘 要 】

Abstract Background Depression 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. Methods This 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. Results The 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). Conclusions Pre-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.

【 授权许可】

Unknown