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.
Mace
Jess
J
Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Portland, OR 97239, USA.
Michael
Yvonne L
YL
Carlson
Nichole E
NE
Litvack
Jamie R
JR
Smith
Timothy L
TL
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*