Effects of depression on quality of life improvement after endoscopic sinus surgery.
OBJECTIVE
To determine whether self- reported depression predicts lesser postoperative improvement in health-related quality of life (HRQoL) after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).


METHODS
Prospective open cohort.


METHODS
An adult (> or =18 yr) cohort of 23 patients with depression and 79 patients without depression undergoing ESS were followed for 12 +/- 2 months. Patient characteristics and computed tomography scores were examined preoperatively. Endoscopy scores and two HRQoL measures, the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey, were analyzed pre- and postoperatively. Univariate and multivariate analyses were used to evaluate outcome differences for patients with depression.


RESULTS
There was a significantly higher prevalence of women (P = .002) and longer duration of follow-up (P = .004) for the depressed subgroup. Depressed patients reported significantly lower pre- and postoperative HRQoL scores on all RSDI subscales (P < .05). Without baseline adjustment, depression was not associated with significant differences in postoperative change for disease-specific HRQoL scores (P > .10) in multivariate analysis.


CONCLUSIONS
Depressed patients with CRS present similarly but have worse pre- and postoperative HRQoL scores and experience similar disease-specific QoL improvements from sinus surgery compared with other CRS patients. Sinus surgery is not effective in alleviating the effect of depression on disease-specific HRQoL, and it is likely that comorbid depression and CRS are operating on independent disease pathways. Additional research and hypothesis testing using continuous, objective measures is warranted.
Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Portland, OR 97239, USA.
Jess
J
Mace
Yvonne L
YL
Michael
Nichole E
NE
Carlson
Jamie R
JR
Litvack
Timothy L
TL
Smith
D003863:Depression / Q000150:complications*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications* / Q000601:surgery*; D012852:Sinusitis / Q000150:complications* / Q000601:surgery*