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Endoscopic Sinus Surgery in Older Patients With Significant Medical Comorbidities.
Huang, Ryan J; Teitelbaum, Jordan I; Issa, Khalil; Truong, Tracy; Kim, Heewon; Kuchibhatla, Maragatha; Hachem, Ralph Abi; Goldstein, Bradley J; Jang, David W.
Afiliación
  • Huang RJ; Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC.
  • Teitelbaum JI; Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC.
  • Issa K; Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC.
  • Truong T; Department of Biostatistics and Bioinformatics, 22957Duke University, Durham, NC.
  • Kim H; Department of Biostatistics and Bioinformatics, 22957Duke University, Durham, NC.
  • Kuchibhatla M; Department of Biostatistics and Bioinformatics, 22957Duke University, Durham, NC.
  • Hachem RA; Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC.
  • Goldstein BJ; Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC.
  • Jang DW; Division of Rhinology & Endoscopic Skull Base Surgery, Department of Head and Neck Surgery & Communication Sciences, 22957Duke University Health System, Durham, NC.
Am J Rhinol Allergy ; 36(5): 661-667, 2022 Sep.
Article en En | MEDLINE | ID: mdl-35578407
BACKGROUND: Endoscopic sinus surgery (ESS) offers excellent outcomes for patients with chronic rhinosinusitis (CRS) in the general population. It is unclear whether older patients with significant medical comorbidities experience similar benefits. OBJECTIVE: The purpose of this study is to evaluate whether increasing medical comorbidity is associated with worse sinonasal quality of life outcomes after ESS in older patients. METHODS: This is a retrospective study of CRS patients 55 years or older who underwent elective ESS at an academic institution from July 2017 to June 2019. 22-Item Sino-Nasal Outcomes Test (SNOT-22) scores were gathered at baseline as well as at 3 and 6 months following surgery. Data on demographics, medical comorbidities, preoperative Lund-Mackay (LM) scores, and postoperative complications were extracted from the medical record. The Charlson Comorbidity Index (CCI) was calculated for each patient. Multivariate linear regression was used to evaluate a potential association between CCI and change in SNOT-22 scores at 3 months postoperatively. RESULTS: A total of 205 patients met inclusion criteria with a mean (SD) CCI score of 2 (2.4) and a CCI score range of 0 to 11. The mean (SD) LM score was 8 (5.3). Rates of asthma and nasal polyposis were 28.3% and 36.6%, respectively. The mean (SD) improvement in SNOT-22 scores at 3 and 6 months compared to baseline was 17.9 (19.7) and 20.9 (18.1) points, respectively. After adjusting for covariates, there was no significant association between CCI and change in SNOT-22 scores. CONCLUSION: Greater medical comorbidity is not associated with worse SNOT-22 outcomes postoperatively, although future studies are needed to determine if comorbidities are associated with higher complication rates. A multidisciplinary approach to perioperative care is critical in maintaining the safety and efficacy of ESS in this patient population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sinusitis / Rinitis Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Humans Idioma: En Revista: Am J Rhinol Allergy Asunto de la revista: ALERGIA E IMUNOLOGIA / OTORRINOLARINGOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sinusitis / Rinitis Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Aged / Humans Idioma: En Revista: Am J Rhinol Allergy Asunto de la revista: ALERGIA E IMUNOLOGIA / OTORRINOLARINGOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos