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Long-term utility outcomes in patients undergoing endoscopic sinus surgery

Authors

  • Luke Rudmik MD,

    Corresponding author
    1. Rhinology and Sinus Surgery, Division of Otolaryngology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
    • Send correspondence to Luke Rudmik, MD, Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Calgary, Foothills Medical Centre, South Tower, Suite 602, 1403-29th St. NW, T2N 2T9 Calgary, Alberta, Canada. E-mail: Lukerudmik@gmail.com

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  • Jess Mace MPH,

    1. Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
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  • Zachary M. Soler MD, MSc,

    1. Division of Rhinology and Sinus Surgery, Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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  • Timothy L. Smith MD, MPH

    1. Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
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  • Jess C. Mace, MPH, Zachary M. Soler, MD, MSc, and Timothy L. Smith, MD, MPH, received grant funding from the National Institute on Deafness and Other Communication Disorders, one of the National Institutes of Health (Bethesda, MD); Public clinical registration (www.clinicaltrial.gov) #NCT00799097. Timothy L. Smith is also a consultant for Intersect ENT (Palo Alto, CA), which provided no financial or administrative support for this investigation.

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

To define long-term health-state utility outcomes in patients undergoing endoscopic sinus surgery (ESS) for refractory chronic rhinosinusitis (CRS).

Study Design

Prospective, longitudinal, cohort study.

Methods

The short-form (SF)−12 survey was issued to the 168 patients who were enrolled in an initial study evaluating short-term utility outcomes following ESS. SF-12 responses were converted into SF-6D utility scores using the University of Sheffield algorithm. The primary outcome was mean overall long-term utility level following ESS. Secondary outcomes evaluated annual utility level following ESS and utility outcomes for different subgroups of patients with CRS.

Results

A total of 83 patients provided long-term health-state utility outcomes. The mean overall long-term utility level was 0.80 at a mean follow-up of 5.2 years after ESS. Compared to the baseline (0.67) and short-term follow-up (0.75) utility levels in this group, there was a significant improvement at the long-term period (P = .002). A total of 54% (45/83) of patients achieved long-term postoperative utility scores higher than the United States norm of 0.81. There was a significant improvement in utility scores for all subsequent years after ESS compared to preoperative responses (all P < .028). All subgroups of CRS received significant long-term utility improvements (all P < .001), and those undergoing revision ESS demonstrated continued improvement past the short-term postoperative period.

Conclusions

This study has demonstrated that patients with refractory CRS achieve stable mean long-term utility levels following ESS and often return to a health state comparable to US population norms.

Level of Evidence

2b. Laryngoscope, 124:19–23, 2014

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