title: Long-term utility outcomes in patients undergoing endoscopic sinus surgery.
abstract: OBJECTIVE
  To define long-term health-state utility outcomes in patients undergoing endoscopic sinus surgery (ESS) for refractory chronic rhinosinusitis (CRS).
  
  
  METHODS
  Prospective, longitudinal, cohort study.
  
  
  METHODS
  The short-form (SF)-12 survey was issued to the 168 patients who were enrolled in an initial study evaluating short-term utility outcomes following ESS. SF-12 responses were converted into SF-6D utility scores using the University of Sheffield algorithm. The primary outcome was mean overall long-term utility level following ESS. Secondary outcomes evaluated annual utility level following ESS and utility outcomes for different subgroups of patients with CRS.
  
  
  RESULTS
  A total of 83 patients provided long-term health-state utility outcomes. The mean overall long-term utility level was 0.80 at a mean follow-up of 5.2 years after ESS. Compared to the baseline (0.67) and short-term follow-up (0.75) utility levels in this group, there was a significant improvement at the long-term period (P = .002). A total of 54% (45/83) of patients achieved long-term postoperative utility scores higher than the United States norm of 0.81. There was a significant improvement in utility scores for all subsequent years after ESS compared to preoperative responses (all P < .028). All subgroups of CRS received significant long-term utility improvements (all P < .001), and those undergoing revision ESS demonstrated continued improvement past the short-term postoperative period.
  
  
  CONCLUSIONS
  This study has demonstrated that patients with refractory CRS achieve stable mean long-term utility levels following ESS and often return to a health state comparable to US population norms.
authors.affiliation: Rhinology and Sinus Surgery, Division of Otolaryngology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Luke
authors.initials: L
authors.lastname: Rudmik
authors.forename: Jess
authors.initials: J
authors.lastname: Mace
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059747:Nasal Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Utility; chronic rhinosinusitis; endoscopic sinus surgery; quality of life; sinusitis