Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2025
Exploring Predictors of Post-Surgical Health-Related Quality of Life and Revision Surgery in Patients With Chronic Rhinosinusitis With Nasal Polyps: A Cohort Study.
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den Heijer Marc C, van der Ven Merel M, Joustra Gonneke E, Vermeulen Karin M, Feijen Robert A, Korsten-Meijer Astrid G W
Аннотация
OBJECTIVES: Functional endoscopic sinus surgery (FESS) has been shown to be effective in improving health-related quality of life (HRQoL) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), though patient selection remains crucial for optimising outcomes. This study aimed to identify predictors of improved postoperative HRQoL and predictors of revision surgery in CRSwNP patients undergoing FESS.
DESIGN: Cohort study.
SETTING: Tertiary referral hospital.
PARTICIPANTS: A total of 153 patients were enrolled in this study. They were asked to fill out the Endonasal Endoscopic Sinus and Skull Base Surgery Questionnaire (EES-Q) preoperatively, and then at 2 weeks, 3 months and 1 year postoperatively.
MAIN OUTCOME MEASURES: Linear mixed model (LMM) analyses were performed to evaluate the overall postoperative HRQoL and the separate health domains, as well as the impact of specific variables (sex, age, ASA classification, smoking, asthma, aspirin-exacerbated respiratory disease, allergic rhinitis, Lund-Mackay score, surgical procedure, postoperative antibiotics, postoperative prednisolone, FESS history, eosinophilia and preoperative EES-Q score) on HRQoL improvement. Using the same variables, a logistic regression analysis was performed to identify predictors of revision surgery.
RESULTS: The total EES-Q score (p < 0.001), as well as the physical (p < 0.001) and social (p < 0.001) domains, significantly improved postoperatively. In the LMM analysis, the preoperative EES-Q score was the only significant variable on the postoperative HRQoL outcome (p < 0.001). Eosinophilia was the only significant variable on revision surgery (p = 0.036).
CONCLUSIONS: FESS significantly improved postoperative HRQoL. Patients reporting worse preoperative HRQoL showed the greatest improvement postoperatively. Proven eosinophilia was the only significant predictor of revision surgery.
DESIGN: Cohort study.
SETTING: Tertiary referral hospital.
PARTICIPANTS: A total of 153 patients were enrolled in this study. They were asked to fill out the Endonasal Endoscopic Sinus and Skull Base Surgery Questionnaire (EES-Q) preoperatively, and then at 2 weeks, 3 months and 1 year postoperatively.
MAIN OUTCOME MEASURES: Linear mixed model (LMM) analyses were performed to evaluate the overall postoperative HRQoL and the separate health domains, as well as the impact of specific variables (sex, age, ASA classification, smoking, asthma, aspirin-exacerbated respiratory disease, allergic rhinitis, Lund-Mackay score, surgical procedure, postoperative antibiotics, postoperative prednisolone, FESS history, eosinophilia and preoperative EES-Q score) on HRQoL improvement. Using the same variables, a logistic regression analysis was performed to identify predictors of revision surgery.
RESULTS: The total EES-Q score (p < 0.001), as well as the physical (p < 0.001) and social (p < 0.001) domains, significantly improved postoperatively. In the LMM analysis, the preoperative EES-Q score was the only significant variable on the postoperative HRQoL outcome (p < 0.001). Eosinophilia was the only significant variable on revision surgery (p = 0.036).
CONCLUSIONS: FESS significantly improved postoperative HRQoL. Patients reporting worse preoperative HRQoL showed the greatest improvement postoperatively. Proven eosinophilia was the only significant predictor of revision surgery.