Predictive factors of a beneficial quality of life outcome in patients undergoing primary sinonasal surgery: a population-based prospective cohort study
To assess predictive factors of a beneficial quality of life (QoL) outcome after primary sinonasal surgery.
A population-based prospective cohort study among 160 adult patients undergoing primary sinonasal surgery (76 septoplasties, SP; 84 endoscopic sinus surgeries, ESS) was conducted. We collected QoL data using the Sinonasal Outcome Test-22 (SNOT-22) before and after surgery. A beneficial QoL outcome was defined as a SNOT-22 score change ≥ 9 points 12 months after surgery. Various demographic, clinical and symptom-related factors predicting a beneficial QoL outcome were sought using binary logistic regression analysis.
The mean age of the patients was 39 years (range 18–61) and 82 (51%) were males. The SNOT-22 score change varied markedly after SP (range − 17 to + 80) and ESS (range − 20 to + 58), but on average it improved (median + 15 after SP and + 16 after ESS). 41 patients (64%) achieved beneficial QoL outcome after SP and 46 (66%) after ESS. In a multivariate analysis, poor QoL before surgery (preoperative SNOT-22 ≥ 20 points) predicted a beneficial QoL outcome after SP and ESS (adjusted odds ratio 10; 95% confidence interval 1.6–64 and 12; 2.5–55, respectively) and a senior surgeon operating after SP (9.9; 1.5–67). On receiver operating characteristic curve analysis, the integer threshold value for the preoperative SNOT-22 score that gave the highest sensitivity (74%) and specificity (70%) was 30.
QoL change after primary SP and ESS varies. A preoperative SNOT-22 score of at least 30 best predicted a beneficial QoL outcome after both procedures.
KeywordsSeptoplasty Endoscopic sinus surgery Quality of life Septal deviation Chronic rhinosinusitis Sinonasal surgery
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest or external funding.
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